| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN INC. | $0 | $2K | $2K | 0.17% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 7660 W CHEYENNE SUITE 109 LAS VEGAS, NV 89129 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $14K | $0 | $14K | 5.11% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $87 | $9K | 14.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 6701 CENTER DRIVE W SUITE 1500 LOS ANGELES, CA 900451561 | METROPOLITAN LIFE INSURANCE COMPANY | $422 | $0 | $422 | 0.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 2158 RIVERSIDE, CA 925162158 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $14 | $14 | 0.02% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 926146271 | METROPOLITAN LIFE INSURANCE COMPANY | -$7 | $18 | $11 | 0.02% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $443 | -$138 | $305 | 0.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES INC | PO BOX 2158 RIVERSIDE, CA 925162158 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | -$27 | -$27 | -0.05% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 926146271 | METROPOLITAN LIFE INSURANCE COMPANY | -$5 | -$47 | -$52 | -0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES INC | 6701 CENTER DR. W SUITE 1500 LOS ANGELES, CA 900451561 | METROPOLITAN LIFE INSURANCE COMPANY | -$934 | $0 | -$934 | -1.78% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 421 | $1.6M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,162 | $274K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,426 | $78K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,162 | $274K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,162 | $274K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,162 | $274K |
| Other(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,162 | $389K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,426 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.