| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $75K | $0 | $75K | 4.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | $0 | $7K | 0.48% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $5K | $5K | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | $292 | $9K | 5.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | DELTA DENTAL OF CALIFORNIA | $16K | $0 | $16K | 10.01% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $704 | $127 | $831 | 3.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 3310 SANTA BARBARA, CA 93130 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $806 | $12 | $818 | 3.41% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $585 | $67 | $652 | 2.71% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $293 | $66 | $359 | 1.49% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $215 | $32 | $247 | 1.03% |
| MJ INSURANCE3 Filed as: ROGER S. KENCHEL AND VARIOUS AGENTS | 2588 EL CAMINO REAL CARLSBAD, CA 92008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $142 | $0 | $142 | 0.59% |
| JOHN A. BRADLEY INC.3 | 207 SOUTH MAIN STREET FOUNTAIN INN, SC 29644 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $68 | $0 | $68 | 0.28% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | THE PAUL REVERE LIFE INSURANCE COMPANY | $35 | $0 | $35 | 1.43% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17 | $0 | $17 | 0.70% |
| JOHN A. BRADLEY INC.3 | 207 SOUTH MAIN STREET FOUNTAIN INN, SC 29644 | THE PAUL REVERE LIFE INSURANCE COMPANY | $16 | $0 | $16 | 0.65% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 264 | $162K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.5M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.5M |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.5M |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.5M |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.7M |
| Other(4 contracts, 4 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.