| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $82K | $855 | $82K | 5.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 600 CORPORATE POINTE CULVER CITY, CA 90230 | AETNA LIFE INSURANCE CO. | $34K | $8K | $42K | 5.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | UNKNOWN YOUNTVILLE, CA 94599 | HEALTH PLAN OF NEVADA | $23K | $0 | $23K | 5.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN RIVERSIDE, CA 92501 | UNITED CONCORDIA INSURANCE COMPANY | $24K | $0 | $24K | 10.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $509 | $5K | 15.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.48% |
| UNKNOWN3 | UNKNOWN RIVERSIDE, CA 92501 | ARMADACARE | $538 | $0 | $538 | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN RIVERSIDE, CA 92501 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $1K | $0 | $1K | 10.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $721 | $0 | $721 | 12.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 600 CORPORATE POINTE CULVER CITY, CA 90230 | SUN LIFE ASSURANCE COMPANY OF CANADA | $148 | $0 | $148 | 2.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2000 SOUTH COLORADO BOULEVARD TOWER 2, SUITE 150 DENVER, CO 80222 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $85 | $85 | 1.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNUM INSURANCE COMPANY | $132 | $13 | $145 | 18.35% |
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 | 396 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 417 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 283 | $2.7M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 425 | $240K |
| Vision | VISION SERVICE PLAN | 240 | $33K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 95 | $34K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 95 | $34K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 95 | $39K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 283 | $2.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 95 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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.