| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | $137K | $17K | $154K | 4.52% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | BLUE CROSS OF CALIFORNIA | $58K | — | $58K | 1.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | P.O. BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 5.51% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $781 | — | $781 | 0.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 10.74% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 4.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. 14TH FL, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 2.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 925162158 | VISION SERVICE PLAN | $1K | — | $1K | 3.14% |
| IMA, INC.3 | P.O. BOX 102833 PASADENA, CA 91189 | VISION SERVICE PLAN | $927 | — | $927 | 2.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. 14TH FL, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 3.12% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $898 | — | $898 | 2.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. 14TH FL, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $880 | $880 | 3.12% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $771 | — | $771 | 2.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 925162158 | RELIASTAR LIFE INSURANCE COMPANY | $3K | — | $3K | 12.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 6701 CENTER DR. W SUITE 1500 LOS ANGELES, CA 900451561 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $1K | $2K | 9.69% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 802021657 | RELIASTAR LIFE INSURANCE COMPANY | $2K | — | $2K | 7.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.86% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $873 | — | $873 | 4.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. 14TH FL, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $273 | $273 | 1.30% |
| IMA, INC.3 Filed as: RONALD WANGLIN - IMA, INC. | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITEDHEALTHCARE INSURANCE COMPANY | $568 | — | $568 | 20.04% |
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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 543 | $3.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 543 | $3.4M |
| Vision | VISION SERVICE PLAN | 179 | $42K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 185 | $66K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 185 | $28K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 185 | $33K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 543 | $3.5M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 543 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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.