| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $81K | $0 | $81K | 5.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 4047 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 0.28% |
| ASHBROOK CLEVIDENCE, INC.3 Filed as: ASHBROOK-CLEVIDENCE, INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | -$8K | $0 | -$8K | -0.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES. INC | PO BOX 4047 CONCORD, CA 94524 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $80 | $28K | 6.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES. INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.58% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET FLOOR 8 BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3000 EXECUTIVE PARKWAY SUITE 300 SAN RAMON, CA 94583 | SUTTER HEALTH PLUS | $9K | $0 | $9K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | WESTERN HEALTH ADVANTAGE | $7K | $0 | $7K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | STERLING LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 4047 CONCORD, CA 94524 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $1K | $0 | $1K | 4.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $0 | $333 | $333 | 1.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $194 | $3K | 39.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN VACAVILLE, CA 95688 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $169 | $0 | $169 | 5.99% |
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 | 1,454 | 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) | 1,454 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 550 | $1.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,668 | $489K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 1,015 | $3K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,668 | $466K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,668 | $466K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 550 | $1.9M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,668 | $473K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,668 | — |
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.