| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN INC. | $39K | $945 | $39K | 3.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $2K | $16K | 17.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 12.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | AETNA LIFE INSURANCE COMPANY | $7K | $5K | $12K | 17.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 14.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM INSURANCE COMPANY | $7K | $1K | $8K | 17.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 37.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $666 | $4K | 16.75% |
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 | 1,003 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,008 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 259 | $1.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 334 | $69K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,149 | $130K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 173 | $94K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 259 | $1.3M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,149 | $235K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,149 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.