| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA | $0 | $148K | $148K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 4047 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLAN INC | $69K | $0 | $69K | 4.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $47K | $21K | $67K | 14.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | $3K | $18K | 3.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3000 EXECUTIVE PARKWAY SUITE 300 SAN RAMON, CA 94583 | METROPOLITAN LIFE INSURANCE COMPANY | $38K | $66 | $38K | 9.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $17K | $17K | 4.37% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 289 | $4.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 656 | $385K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 656 | $385K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $471K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $471K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $471K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 289 | $4.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $471K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 656 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.