| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $83K | — | $83K | 2.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $0 | $10K | 3.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 3.79% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 11.91% |
| GOOD FRIEND INSURANCE SERVICES LLC3 Filed as: GOOD FRIEND INSURANCE SERVICES, LLC | 3580 WILSHIRE BLVD #1510 LOS ANGELES, CA 90010 | EYEMED VISION CARE | $4K | — | $4K | 9.24% |
| GOOD FRIEND INSURANCE SERVICES LLC3 | 3580 WILSHIRE BLVD SUITE 1510 LOS ANGELES, CA 90010 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | — |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N. MAIN STREET STE. 800 SANTA ANA, CA 92705 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $364 | $364 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA | Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Participant communication; Other services; Contract Administrator; Named fiduciary Service code 12 | — | $0 |
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 | Non-monetary compensation; Other services; Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $0 |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 382 | $3.6M |
| Dental(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 264 | $272K |
| Vision | EYEMED VISION CARE | 602 | $38K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 264 | $272K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 264 | $272K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 602 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.