| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 3310 SANTA BARBARA, CA 93130 | UNITEDHEALTHCARE INSURANCE COMPANY | $65K | $0 | $65K | 4.25% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 380 TORRANCE, CA 90503 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | $0 | $13K | 0.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $3K | $3K | 0.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | DELTA DENTAL OF CALIFORNIA | $13K | $0 | $13K | 7.55% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET, SUITE 21 LOS ANGELES, CA 90017 | DELTA DENTAL OF CALIFORNIA | $4K | $0 | $4K | 2.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $271 | $6K | 4.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 12.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 55 EAST JACKSON, 12TH FLOOR CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.23% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.34% |
| MCAREY INC.3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $635 | $38 | $673 | 2.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 3310 SANTA BARBARA, CA 93130 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $661 | $10 | $671 | 2.45% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $448 | $22 | $470 | 1.72% |
| ROGER STUART KENCHEL3 Filed as: ROGER STUART KENCHEL & OTHER AGENTS | 2588 EL CAMINO REAL CARLSBAD, CA 92008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $229 | $10 | $239 | 0.87% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $229 | $4 | $233 | 0.85% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSTHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $116 | $18 | $134 | 0.49% |
| JOHN A. BRADLEY INC.3 | 207 SOUTH MAIN STREET FOUNTAIN INN, SC 29644 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $73 | $0 | $73 | 0.27% |
| MCAREY INC.3 | 965 MESA DRIVE CAMARILLO, CA 93010 | THE PAUL REVERE LIFE INSURANCE COMPANY | $117 | $0 | $117 | 2.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 3310 SANTA BARBARA, CA 93130 | THE PAUL REVERE LIFE INSURANCE COMPANY | $103 | $0 | $103 | 1.90% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | THE PAUL REVERE LIFE INSURANCE COMPANY | $55 | $0 | $55 | 1.02% |
| DEL DOWNEY3 | 32056 MERLOT CRESCENT TERNECULA, CA 92591 | THE PAUL REVERE LIFE INSURANCE COMPANY | $25 | $0 | $25 | 0.46% |
| PAULETTE VICTORIA WALKER3 | 1425 PARK PLACE BROOKLYN, NY 11213 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.02% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 266 | $1.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 266 | $166K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 266 | $1.5M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $61K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $61K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $61K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 266 | $1.7M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.