| 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 | $63K | $765 | $64K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 16030 VENTURA BOULEVARD SUITE 500 ENCINO, IL 91436 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.16% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 5335 YARMOUTH AVENUE, SUITE 106 ENCINO, CA 91316 | AFLAC | $2K | $54 | $2K | 4.34% |
| MJ INSURANCE3 Filed as: GNW-EVERGREEN & VARIOUS AGENTS | PO BOX 20005 ENCINO, CA 91416 | AFLAC | $1K | $0 | $1K | 2.98% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $1K | $13 | $1K | 2.90% |
| LIVIER MARIA RAMIREZ3 Filed as: LIVIER RAMIREZ | 1107 FAIR OAKS AVENUE, SUITE 882 SOUTH PASADENA, CA 91030 | AFLAC | $946 | $0 | $946 | 2.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | AFLAC | $489 | $0 | $489 | 1.17% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1620 SOUTH DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $248 | $13 | $261 | 0.63% |
| RHOEL T VALDEZ3 Filed as: RHOEL VALDEZ | 20016 BLYTHE STREET WINNETKA, CA 91306 | AFLAC | $210 | $0 | $210 | 0.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16030 VENTURA BOULEVARD ENCINO, IL 91436 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.82% |
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 | 235 | 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) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 264 | $1.3M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 93 | $95K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 236 | $15K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 93 | $95K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 93 | $95K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 93 | $95K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 264 | $1.3M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 235 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.