| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DR., BLDG M3 RIVERSIDE, CA 92506 | UNITED HEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 5.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DR., BLDG M3 RIVERSIDE, CA 92506 | UNION SECURITY INSURANCE COMPANY | $39 | — | $39 | 0.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DR., BLDG M3 RIVERSIDE, CA 92506 | UNION SECURITY INSURANCE COMPANY | $126 | — | $126 | 7.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DR., BLDG M3 RIVERSIDE, CA 92506 | UNION SECURITY INSURANCE COMPANY | $234 | — | $234 | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DR., BLDG M3 RIVERSIDE, CA 92506 | UNION SECURITY INSURANCE COMPANY | $120 | — | $120 | 14.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DR., BLDG M3 RIVERSIDE, CA 92506 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $49 | — | $49 | 10.04% |
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 | 623 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 625 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 379 | $196K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 469 | $20K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 469 | $20K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 623 | $22K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 37 | $802 |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 469 | $20K |
| Other(3 contracts) | UNION SECURITY INSURANCE COMPANY | 623 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 623 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.