| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMAENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $49K | $0 | $49K | 5.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1K | $1K | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMAENTO, CA 95865 | SUTTER HEALTH PLAN | $20K | $0 | $20K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMAENTO, CA 95865 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 2.95% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS., LLC | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 1.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMAENTO, CA 95865 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $7K | 17.53% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS., LLC | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$1 | $2K | $2K | 3.93% |
| T2B SOLUTIONS INC.3 Filed as: T2B SOLUTIONS, INC. | 1214 NORTH B STREET INDIANOLA, IA 50125 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $268 | $268 | 0.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $2K | $0 | $2K | 9.14% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $104 | $0 | $104 | 0.46% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 25 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 143 | $1.3M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 284 | $82K |
| Vision | VISION SERVICE PLAN | 187 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $42K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $42K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 143 | $1.3M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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.