| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | $4K | $27K | 4.30% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | $1 | $8K | 1.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY, SUITE 300 SAN RAMON, CA 94583 | SUTTER HEALTH PLAN | $20K | — | $20K | 3.80% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | SUTTER HEALTH PLAN | $6K | — | $6K | 1.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY, SUITE 300 SAN RAMON, CA 94583 | PREMIER ACCESS INSURANCE COMPANY | $4K | — | $4K | 3.43% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | PREMIER ACCESS INSURANCE COMPANY | $1K | — | $1K | 1.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY, SUITE 300 SAN RAMON, CA 94583 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 7.57% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | UNITED HEALTHCARE INSURANCE COMPANY | $428 | — | $428 | 2.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92506 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.21% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED HEALTHCARE INSURANCE COMPANY | $290 | — | $290 | 2.40% |
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 | 294 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 103 | $1.2M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 145 | $113K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 144 | $18K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 168 | $12K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 103 | $1.2M |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 168 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.