| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 255387 SACRAMENTO, CA 95865 | UNITEDHEALTHCARE INSURANCE COMPANY | $37K | $0 | $37K | 2.98% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | PO BOX 255188 SACRAMENTO, CA 95865 | UNITEDHEALTHCARE INSURANCE COMPANY | $28K | $0 | $28K | 2.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $5K | $5K | 0.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $21K | $0 | $21K | 2.78% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE BUILDING 3 SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 2.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $236 | $9K | 4.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $6K | $6K | 3.23% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | PO BOX 8110 CHICO, CA 95927 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 7.91% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | PO BOX 255188 SACRAMENTO, CA 95865 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.29% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | PO BOX 8110 CHICO, CA 95927 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.12% |
| JAMES BULOTTI, JR.3 Filed as: JAMES BULOTTI JR. | 8950 CAL CENTER DRIVE SACRAMENTO, CA 95826 | LANDMARK HEALTHPLAN | $457 | $0 | $457 | 10.01% |
| LYNN GREENE3 | PO BOX 2158 RIVERSIDE, CA 92506 | LANDMARK HEALTHPLAN | $457 | $0 | $457 | 10.01% |
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 | 190 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 179 | $2.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 343 | $201K |
| Vision | VISION SERVICE PLAN | 155 | $26K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 190 | $79K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 190 | $79K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 190 | $79K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 179 | $2.0M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 343 | $285K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
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.