| 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 92516 | KAISER FOUNDATION HEALTH PLAN INC | $68K | $610 | $69K | 5.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | $2K | $10K | 7.00% |
| DAVID JACOB HOLPER3 Filed as: DAVID HOLPER | 1828 WEST 244TH STREET TORRANCE, CA 90501 | AFLAC | $7K | $213 | $7K | 11.37% |
| MJ INSURANCE3 Filed as: SABRINA WARREN & VARIOUS AGENTS | 4562 NEWMAN AVENUE CYPRESS, CA 90630 | AFLAC | $1K | $15 | $2K | 2.46% |
| SEAN C. ARENS3 Filed as: SEAN ARENS | 5904 WARNER AVENUE, SUITE A 127 HUNTINGTON BEACH, CA 92649 | AFLAC | $996 | $50 | $1K | 1.71% |
| PEREZ BENEFITS CONSULTANT LLC3 | PO BOX 555 RIDGEWOOD, NJ 07451 | AFLAC | $891 | $3 | $894 | 1.47% |
| NICHOLAS K. GREEN3 Filed as: NICHOLAS GREEN | 4341 MARION AVENUE CYPRESS, CA 90630 | AFLAC | $719 | $50 | $769 | 1.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | AFLAC | $560 | $0 | $560 | 0.92% |
| CLAY W CAMPBELL3 Filed as: CLAY CAMPBELL | 14720 LIBLEN AVENUE BELLFLOWER, CA 90706 | AFLAC | $211 | $0 | $211 | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE | $723 | $0 | $723 | 10.00% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 192 | $1.4M |
| Dental(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 192 | $1.3M |
| Vision | AFLAC | 108 | $61K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 192 | $1.4M |
| Other | AFLAC | 108 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.