| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $50K | $2K | $52K | 5.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 16030 VENTURA BOULEVARD, SUITE 500 ENCINO, CA 91436 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $2K | $9K | 13.77% |
| LINDA M NAPOLI3 Filed as: LINDA M. NAPOLI | 5335 YARMOUTH AVENUE APARTMENT 106 ENCINO, CA 91316 | AFLAC | $3K | $257 | $3K | 7.63% |
| ELIZABETH ASH CHAVKIN3 Filed as: ELIZABETH CHAVKIN AND OTHER AGENTS | 316 WEST 2ND STREET, SUITE 500 LOS ANGELES, CA 90012 | AFLAC | $2K | $136 | $2K | 5.22% |
| PATRICIA GAIL LEES3 | 6055 EAST WASHINGTON BOULEVARD SUITE 210 COMMERCE, CA 90040 | AFLAC | $2K | $210 | $2K | 5.16% |
| LIVIER MARIA RAMIREZ3 | 1107 FAIR OAKS AVENUE, UNIT 882 SOUTH PASADENA, CA 91030 | AFLAC | $1K | $0 | $1K | 2.63% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK AND V | 1620 SOUTH DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $680 | $66 | $746 | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | AFLAC | $389 | $0 | $389 | 0.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2393 TOWNSGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $242 | $0 | $242 | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16030 VENTURA BOULEVARD ENCINO, CA 91436 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | — | $1K | 9.81% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 239 | $1000K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $64K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 164 | $13K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $64K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $64K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $64K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 239 | $1000K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 400 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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.