| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | UNITED CONCORDIA INSURANCE COMPANY | $19K | $23K | $42K | 8.88% |
| WES BRADFORD INSURANCE SALES INC3 Filed as: WES BRADFORD INSURANCE | 1515 20TH ST BAKERSFIELD, CA 93301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $0 | $11K | 5.22% |
| LORI ROBIN NISHIMORI3 | 9204 HOXIE CT BAKERSFIELD, CA 93311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $4 | $7K | 3.19% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $698 | $3K | 1.57% |
| CHRISTINE A MILLER3 Filed as: CHRISTINE MILLER | 715 AVOCET WAY ARROYO GRANDE, CA 93420 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.99% |
| REBECCA KIM VIALL3 | 304 28TH ST NW MINOT, ND 58703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $23 | $2K | 0.98% |
| VONDA KAY PERALEZ3 | 6409 RIO DE JANEIRO AVE BAKERSFIELD, CA 93313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $5 | $1K | 0.58% |
| BART EHINGER3 | 715 AVOCET WAY ARROYO GRANDE, CA 93420 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $829 | $0 | $829 | 0.38% |
| OMAR MENDOZA3 | 26326 ROCKWALL PKWY NEW BRAUNFELS, TX 78132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $532 | $154 | $686 | 0.31% |
| BILLY MARK ROBERSON3 | 17415 SHADY CANYON SAN ANTONIO, TX 78266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $619 | $26 | $645 | 0.30% |
| MICHAEL ANTHONY CHANDLER3 | 9839 COMMON LAW CONVERSE, TX 78109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $346 | $0 | $346 | 0.16% |
| SUSAN GOLD STOKES3 | 17042 PINEHURST LN #D HUNTIGNTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | $0 | $130 | 0.06% |
| EDWIN MANUEL VELASQUEZ3 Filed as: EDWIN MANUAL VELASQUEZ | 33013 SEVILLE ST LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $0 | $113 | 0.05% |
| CHRISTINA NOEL MCQUISTON3 | 2203 ARLINGTON ST BAKERSFIELD, CA 93305 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $0 | $85 | 0.04% |
| THOMAS SNYDER3 | 9385 MILLER LANE GARDEN RIDGE, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $55 | $82 | 0.04% |
| JOEL WARREN VIALL3 | PO BOX 785 MINOT, ND 58702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.02% |
| HORIZON BENEFITS LLC3 | 9385 MILLER LANE GARDEN RIDGE, TX 78266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $0 | $40 | 0.02% |
| ARACELI MEDINA PANIAGUA3 | 400 ROYAL WAY BAKERSFIELD, CA 93306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | $0 | $11K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2158 RIVERSIDE, CA 925162158 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $3K | $10K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 ADMINISTRATIVE | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $120K |
| HUB INTERNATIONAL INSURANCE SERVICE ADMINISTRATIVE | Insurance agents and brokers; Non-monetary compensation; Other commissions Service code 22 | PO BOX 3310 SANTA BARBARA, CA 93130 | $0 |
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 | 935 | 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) | 935 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 1,594 | $474K |
| Vision | VISION SERVICE PLAN | 622 | $87K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 935 | $285K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 135 | $218K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 349 | $108K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 935 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,594 | — |
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.