| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $43K | $43K | 5.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $2 | $10K | 4.99% |
| BLADWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $54 | $54 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 255387 SACRAMENTO, CA 95865 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 NORTH LASALLE STREET, FLOOR 20 CHICAGO, IL 60601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $116 | $116 | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATINAL INS SERVICES INC | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $44 | $1K | 1.62% |
| BLADWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $534 | $534 | 0.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $455 | $455 | 0.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVCES INC | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | $1K | $0 | $1K | 14.81% |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 98 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 243 | $71K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | 171 | $8K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 97 | $92K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 97 | $92K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 97 | $92K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 98 | $1.0M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 97 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.