| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC | $111K | $5K | $116K | 3.88% |
| LYNN INSURANCE SERVICES3 | 531 ENCINITAS BLVD, STE 111 ENCINITAS, CA 92024 | KAISER FOUNDATION HEALTH PLAN INC | $48K | — | $48K | 1.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC | $57K | $2K | $59K | 3.64% |
| LYNN INSURANCE SERVICES3 | 531 ENCINITAS BLVD, STE 111 ENCINITAS, CA 92024 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 1.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | PRINCIPAL LIFE INSURANCE COMPANY | $49K | $12K | $61K | 7.86% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $24K | $8K | $32K | 4.15% |
| LYNN INSURANCE SERVICES3 | 531 ENCINITAS BLVD, STE 111 ENCINITAS, CA 92024 | PRINCIPAL LIFE INSURANCE COMPANY | $21K | — | $21K | 2.67% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | — | $18K | 25.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $248 | $8K | 11.21% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 6.38% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | — | $14K | 23.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $220 | $6K | 10.48% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 6.27% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | — | $12K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $199 | $5K | — |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | — |
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 | 1,073 | 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) | 1,073 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 713 | $4.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 1,073 | $774K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 1,073 | $774K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,073 | $774K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 713 | $4.6M |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 699 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,073 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.