| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92600 | UNITEDHEALTHCARE INSURANCE COMPANY | $33K | $0 | $33K | 1.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 1.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92600 | UNITEDHEALTHCARE | $45K | $0 | $45K | 14.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | ARAG INSURANCE COMPANY | $5K | $0 | $5K | 15.00% |
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 | 1,037 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,045 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,866 | $2.6M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,866 | $1.9M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,866 | $1.9M |
| Life insurance | UNITEDHEALTHCARE | 1,497 | $303K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 996 | $479K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 996 | $479K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,866 | $2.6M |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE | 1,497 | $338K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,866 | — |
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."
No prospect flags tripped on this filing.