| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 3435 WILSHIRE BOULEVARD, SUITE 3000 LOS ANGELES, CA 90010 | UNITEDHEALTHCARE INSURANCE COMPANY | $73K | — | $73K | 4.92% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $4K | $4K | 0.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $10K | $2K | $12K | 11.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 10.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $748 | $748 | 2.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 28.94% |
| MICHELLE ANN DERAS3 Filed as: MICHELLE A DERAS | PO BOX 365 WEST COVINA, CA 91793 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 17.35% |
| RENEE SUZANNE CORSO3 Filed as: RENEE S CORSO | 5805 SEPULVEDA BOULEVARD, SUITE 740 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $783 | $0 | $783 | 4.77% |
| RUBEN ROSA3 | 5805 SEPULVEDA BOULEVARD, SUITE 700 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $749 | $0 | $749 | 4.56% |
| YOLANDA JOY RICHMAN3 Filed as: YOLANDA J RICHMAN | 10000 NEVADA AVENUE CHATSWORTH, CA 91311 | CONTINENTAL AMERICAN INSURANCE COMPANY | $374 | $0 | $374 | 2.28% |
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 | 163 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 239 | $1.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 234 | $104K |
| Vision | BLUE CROSS OF CALIFORNIA | 234 | $104K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $36K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $36K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 239 | $1.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.