| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $54K | — | $54K | 0.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $188K | $24K | $212K | 11.25% |
| ZUMAN INC DBA ZUMAN INC ADMIN5 Filed as: ZUMAN INC DBA ZUMAN INC ADMINISTRAT | 5994 W LAS POSITAS BLVD STE 225 PLEASANTON, CA 94588 | METROPOLITAN LIFE INSURANCE COMPANY | — | $36K | $36K | 1.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | — | $143 | $143 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $13K | $13K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $14K | $14K | 13.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $12K | $12K | 13.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 15.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 13.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUB INTERNATIONAL EIN 45-4645646 PLAN SERVICE PROVIDER | Insurance agents and brokers Service code 22 | 9855 SCRANTON ROAD SAN DIEGO, CA 92121 | $1.2M |
| TABULERA, INC. EIN 45-5251240 PLAN SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 5994 W. LAS POSITAS BLVD STE 117 PLEASANTON, CA 94588 | $398K |
| ABD INSURANCE AND FINANCIAL SERVICE EIN 27-0673528 PLAN SERVICE PROVIDER | Insurance agents and brokers Service code 22 | 3 WATERS PARK DR #100 SAN MATEO, CA 94403 | $397K |
| GRAND ROUNDS, INC. EIN 45-3580052 PLAN SERVICE PROVIDER | Insurance services Service code 23 | 360 3RD ST. STE 425 SAN FRANCISCO, CA 94107 | $140K |
| WOODRUFF-SAWYER & CO EIN 94-1625126 PLAN SERVICE PROVIDER | Consulting (general); Insurance agents and brokers Service code 16 | 50 CALIFORNIA ST 12TH FLOOR SAN FRANCISCO, CA 94111 | $128K |
| IGOE AND COMPANY EIN 95-3391660 PLAN SERVICE PROVIDER | Plan Administrator Service code 14 | 1905 TECHNOLOGY PLACE STE A SAN DIEGO, CA 92127 | $43K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 PLAN SERVICE PROVIDER | Accounting (including auditing) Service code 10 | 915 HIGHLAND POINTE DR STE 300 ROSEVILLE, CA 95678 | $38K |
| FISHER & PHILLIPS LLP EIN 58-0619559 PLAN SERVICE PROVIDER | Legal Service code 29 | 2050 MAIN STREET STE 1000 IRVINE, CA 92614 | $26K |
| KEY BANK PLAN SERVICE PROVIDER | Other fees Service code 99 | P.O. BOX 93885 CLEVELAND, OH 441015885 | $8K |
| TRAVELERS CASUALTY & SURETY COMPANY PLAN SERVICE PROVIDER | Insurance services Service code 23 | P.O. BOX 6512 DIAMOND BAR, CA 91765 | $5K |
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 | 1,908 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,951 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,516 | $22.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,328 | $1.9M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 2,328 | $1.9M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,279 | $360K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,084 | $107K |
| Other(5 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,279 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,328 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.