| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 421 W 3RD ST, STE 800 FORT WORTH, TX 76102 | KAISER FOUNDATION HEALTH PLAN INC | $78K | $0 | $78K | 4.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVS OF CA | 3697 MT DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $77K | $0 | $77K | 7.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 NORTH CENTRAL EXPY, STE 1200 DALLAS, TX 75231 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $32K | $0 | $32K | 2.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CTR | 3697 MT DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $2K | $13K | 1.17% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVS OF CA | 3697 MT DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$629 | $0 | -$629 | -0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 6.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 2924 KNIGHT ST, STE 370 SHREVEPORT, LA 71105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 3.88% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | 3697 MT DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $139 | $2K | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 3221 COLLINSWORTH ST FORTH WORTH, TX 76107 | AMERITAS LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.81% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | AMERITAS LIFE INSURANCE COMPANY | $643 | $0 | $643 | 1.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 13.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 2924 KNIGHT ST, STE 370 SHREVEPORT, LA 71105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 4.36% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $418 | $35 | $453 | 1.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC- | DBA IPS ADVISORS 421 W 3RD ST, STE 800 FORT WORTH, TX 76102 | KAISER FOUNDATION HEALTH PLAN, INC | $259 | $0 | $259 | 1.69% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVS OF CA-SITZMAN | 3697 MT. DIABLO BLVD, STE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN, INC | $125 | $0 | $125 | 0.82% |
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 | 435 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 436 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 356 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 430 | $1.1M |
| Vision | AMERITAS LIFE INSURANCE COMPANY | 910 | $54K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 636 | $154K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 636 | $125K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 636 | $125K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 430 | $1.1M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 636 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 910 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.