| 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. | $104K | $2 | $104K | 4.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16030 VENTURA BOULEVARD, SUITE 500 ENCINO, CA 91436 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | $0 | $16K | 10.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 203 N LASALLE STREET, 20TH FLOOR CHICAGO, IL 60601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $89 | $89 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16030 VENTURA BOULEVARD, SUITE 500 ENCINO, CA 91436 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 12.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92502 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 12.07% |
| LINDA M NAPOLI3 Filed as: LINDA M. NAPOLI | 17631 VENTURA BOULEVARD, SUITE 321 ENCINO, CA 91316 | AFLAC | $230 | — | $230 | 5.11% |
| MJ INSURANCE3 Filed as: DANIEL C. HARRIS AND VARIOUS AGENTS | 413 OAK RIDGE COURT MARS, PA 16046 | AFLAC | $188 | $0 | $188 | 4.17% |
| MARIA ANTONIA VIVANCO3 | 37654 HAMMER STREET PALMDALE, CA 93552 | AFLAC | $163 | $0 | $163 | 3.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | AFLAC | $161 | $0 | $161 | 3.57% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $117 | $0 | $117 | 2.60% |
| LIVIER MARIA RAMIREZ3 | 1201 TOLEDO STREET LOS ANGELES, CA 90042 | AFLAC | $73 | $0 | $73 | 1.62% |
| RHOEL T. VALEZ3 | 20016 BLYTHE STREET WINNETKA, CA 91306 | AFLAC | $58 | $0 | $58 | 1.29% |
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 | 201 | 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) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 311 | $2.1M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $153K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 326 | $16K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $153K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $153K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $153K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 311 | $2.1M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.