| 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 | $94K | $2 | $94K | 5.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $9K | $0 | $9K | 5.79% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 1.39% |
| DAVID JACOB HOLPER3 | 1828 WEST 244TH STREET TORRANCE, CA 90501 | AFLAC | $8K | $373 | $8K | 11.62% |
| MJ INSURANCE3 Filed as: CLAY W. CAMPBELL AND VARIOUS AGENTS | 14720 LIBLEN AVENUE BELLFLOWER, CA 90706 | AFLAC | $1K | $0 | $1K | 1.98% |
| PEREZ BENEFITS CONSULTANT LLC3 | PO BOX 555 RIDGEWOOD, NJ 07451 | AFLAC | $1K | $0 | $1K | 1.68% |
| NICHOLAS K. GREEN3 | 14811 SAN JOSE AVENUE PARAMOUNT, CA 90723 | AFLAC | $968 | $87 | $1K | 1.50% |
| SABRINA TAYLOR WARREN3 | 4562 NEWMAN AVENUE CYPRESS, CA 90630 | AFLAC | $803 | $29 | $832 | 1.18% |
| SEAN C. ARENS3 | 5904 WARNER AVENUE, SUITE A HUNTINGTON BEACH, CA 92649 | AFLAC | $758 | $58 | $816 | 1.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | AFLAC | $493 | $0 | $493 | 0.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE | $696 | $0 | $696 | 10.98% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 220 | $2.0M |
| Dental(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 220 | $1.8M |
| Vision(2 contracts, 2 carriers) | AFLAC | 116 | $77K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 220 | $1.9M |
| Other | AFLAC | 116 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.