| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST INS | 55 EAST JACKSON BOULEVARD 12TH FLOOR CHICAGO, IL 60604 | CALIFIRNIA PHYSICIANS SERVICE | $16K | $107K | $123K | 5.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST INS | 55 EAST JACKSON BOULEVARD 12TH FLOOR CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN INC | $19K | $0 | $19K | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST INS | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $13K | 12.96% |
| JOHN M FICKEWIRTH AND ASSOCIATION I3 Filed as: JOHN FICKEWIRTH & ASSOCIATES | 60 SOUTH CALIFORNIA STREET 4TH FLOOR VENTURA, CA 93001 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 1.54% |
| SHANBROM WILLIAM AND ASSOCIATES3 | 603 WEST OJAI AVENUE OJAI, CA 93023 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.45% |
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 | 359 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 369 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFIRNIA PHYSICIANS SERVICE | 443 | $2.6M |
| Dental | CALIFIRNIA PHYSICIANS SERVICE | 443 | $2.2M |
| Vision | CALIFIRNIA PHYSICIANS SERVICE | 443 | $2.2M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 614 | $102K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 614 | $102K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 614 | $102K |
| Prescription drug(2 contracts, 2 carriers) | CALIFIRNIA PHYSICIANS SERVICE | 443 | $2.6M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 614 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 614 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.