| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL OF CALIFORNIA INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $21K | $2K | $24K | 3.78% |
| DIVERSIFIED INSURANCE GROUP3 | 95 SOUTH STATE STREET SUITE 1300 SALT LAKE CITY, UT 84111 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $0 | $8K | 1.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | UNKNOWN RIVERSIDE, CA 92501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $53K | $19K | $72K | 15.01% |
| IMA, INC.3 | UNKNOWN DALLAS, TX 75240 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 4.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | UNKNOWN HOLLADAY, UT 84121 | DELTA DENTAL OF CALIFORNIA | $19K | $0 | $19K | 12.55% |
| DIVERSIFIED INSURANCE3 Filed as: DIVERSIFIED INSURANCE, INC. | UNKNOWN HOLLADAY, UT 84121 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 5.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | HEALTHIEST YOU | $269 | — | $269 | 10.01% |
| IMA, INC.3 | 430 EAST DOUGLAS AVENUE SUITE 400 WICHITA, KS 67202 | HEALTHIEST YOU | $134 | — | $134 | 4.99% |
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 | 732 | 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) | 732 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 83 | $628K |
| Dental | DELTA DENTAL OF CALIFORNIA | 507 | $148K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 732 | $477K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 732 | $477K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 732 | $477K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 732 | $477K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 83 | $625K |
| Other(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 900 | $494K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 900 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.