| 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. | $71K | $3 | $71K | 4.93% |
| 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 | $10K | $0 | $10K | 10.30% |
| LINDA M NAPOLI3 Filed as: LINDA M. NAPOLI | 17631 VENTURA BOULEVARD, SUITE 321 ENCINO, CA 91316 | AFLAC | $2K | $167 | $2K | 4.72% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $1K | $39 | $1K | 3.08% |
| EVERGREEN INS. SVCS. & OTHER AGENTS3 | PO BOX 20005 ENCINO, CA 91416 | AFLAC | $999 | $0 | $999 | 2.66% |
| LIVIER MARIA RAMIREZ3 | 1201 TOLEDO STREET LOS ANGELES, CA 90042 | AFLAC | $784 | $0 | $784 | 2.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | AFLAC | $499 | $0 | $499 | 1.33% |
| RHOEL T VALDEZ3 Filed as: RHOEL T. VALDEZ | 20016 BLYTHE STREET WINNETKA, CA 91306 | AFLAC | $240 | $39 | $279 | 0.74% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK | 1620 SOUTH DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $195 | $0 | $195 | 0.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 16030 VENTURA BOULEVARD, SUITE 500 ENCINO, CA 91436 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.92% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 264 | $1.4M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 98 | $94K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 266 | $18K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 98 | $94K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 98 | $94K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 98 | $94K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 264 | $1.4M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 98 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.