| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $14 | $54K | $54K | 3.02% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | CALIFORNIA PHYSICIANS SERVICE | $12 | $40K | $40K | 2.24% |
| 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 | 3.16% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 2.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | UNKNOWN SAN DIEGO, CA 92121 | DELTA DENTAL OF CALIFORNIA | $12K | $0 | $12K | 5.56% |
| LUMITY, INC.3 Filed as: LUMITY INC | UNKNOWN SAN DIEGO, CA 92121 | DELTA DENTAL OF CALIFORNIA | $10K | $0 | $10K | 4.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 8.56% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 6.44% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $27 | $0 | $27 | 0.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 20.00% |
| ENROLLEASE3 | 660 YORK STREET, SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $129 | $0 | $129 | 0.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $446 | $0 | $446 | 2.40% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $149 | $0 | $149 | 0.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | MUTUAL OF OMAHA INSURANCE COMPANY | $606 | $0 | $606 | 10.03% |
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 368 | $2.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 497 | $217K |
| Vision | VISION SERVICE PLAN | 221 | $31K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 220 | $89K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 220 | $89K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 220 | $89K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 368 | $2.2M |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 220 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 497 | — |
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.