| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $55K | $0 | $55K | 2.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $402 | $402 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6565 AMERICANS PARKWAY NE SUITE 720 ALBUQUERQUE, NM 87110 | METROPOLITAN LIFE INSURANCE COMPANY | $110K | $225 | $110K | 11.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6565 AMERICAS PARKWAY NE SUITE 720 ALBUQUERQUE, NM 87110 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $45 | $15K | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 CHICAGO, IL 92501 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $9K | $0 | $9K | 1.50% |
| GAVIN TOMA3 | 737 BISHOP STREET, SUITE 1200 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $9K | $0 | $9K | 1.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6565 AMERICANS PARKWAY NE SUITE 720 ALBUQUERQUE, NM 87110 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $522 | $0 | $522 | 3.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6565 AMERICANS PARKWAY NE SUITE 720 ALBUQUERQUE, NM 87110 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $57 | $0 | $57 | 3.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6565 AMERICANS PARKWAY NE SUITE 720 ALBUQUERQUE, NM 87110 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $43 | $0 | $43 | 4.28% |
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 | 1,654 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,665 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 243 | $2.7M |
| Dental(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,187 | $970K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,187 | $954K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,187 | $954K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,187 | $954K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,187 | $954K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 243 | $2.7M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 450 | $0 |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,187 | $954K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,187 | — |
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.