| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $112 | $233K | $233K | 4.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $37K | $0 | $37K | 3.83% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN. INC. | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $44 | $60K | $60K | 8.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | METROPOLITAN LIFE INSURANCE COMPANY | $48K | $188 | $49K | 6.66% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $0 | $17K | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.35% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.32% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE | 101 SOUTH GARLAND AVENUE, SUITE 200 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $603 | $0 | $603 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $7K | $0 | $7K | 13.86% |
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 | 387 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 564 | $5.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $730K |
| Vision | VISION SERVICE PLAN | 315 | $48K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $730K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $730K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $730K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 564 | $5.8M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $730K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 757 | — |
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.