| 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. | $87K | $0 | $87K | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 16030 VENTURA BOULEVARD. SUITE 500 ENCINO, CA 91436 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.33% |
| LINDA M NAPOLI3 | 17631 VENTURA BOULEVARD SUITE 321 ENCINO, CA 91316 | AFLAC | $3K | $93 | $3K | 5.68% |
| DANIEL C HARRIS3 Filed as: DANIEL C HARRIS AND OTHER AGENTS | 413 OAK RIDGE COURT WINNETKA, CA 91306 | AFLAC | $2K | $0 | $2K | 4.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | AFLAC | $2K | $0 | $2K | 3.24% |
| MARIA ANTONIA VIVANCO3 | 37654 HAMMER STREET PALMDALE, CA 93552 | AFLAC | $2K | $4 | $2K | 3.23% |
| PATRICIA GAIL LEES3 | 1124 CHURCH COURT BURBANK, CA 91501 | AFLAC | $1K | $18 | $1K | 2.65% |
| LIVIER MARIA RAMIREZ3 | 1201 TOLEDO STREET LOS ANGELES, CA 90042 | AFLAC | $781 | $0 | $781 | 1.65% |
| ROHEL T VALDEZ3 | 20016 BLYTHE STREET WINNETKA, CA 91306 | AFLAC | $611 | $18 | $629 | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16030 VENTURA BOULEVARD, SUITE 500 ENCINO, CA 91436 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.84% |
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 | 270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 291 | $1.7M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 114 | $122K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 317 | $20K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 114 | $122K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 114 | $122K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 114 | $122K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 291 | $1.7M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 114 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.