| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | BLUE CROSS OF CALIFORNIA | $233K | $18K | $251K | 6.24% |
| CHUNHA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BOULEVARD GARDEN GROVE, CA 92844 | BLUE CROSS OF CALIFORNIA | $10 | $0 | $10 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $1 | $8K | 2.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 1.69% |
| CHUN-HA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BOULEVARD GARDEN GROVE, CA 92844 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 0.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 2.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $3K | $0 | $3K | 6.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | RELIASTAR LIFE INSURANCE COMPANY | $7K | $0 | $7K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.95% |
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 | 426 | 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) | 426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 767 | $4.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 767 | $4.0M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 767 | $4.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 426 | $169K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 426 | $169K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 426 | $169K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 767 | $4.4M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 767 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 767 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.