| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 3310 SANTA BARBARA, CA 93130 | ANTHEM BLUE CROSS | $13K | $0 | $13K | 1.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLAN INC | $40K | $0 | $40K | 4.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFRONIA | 580 CALIFORNIA STREET SAN FRANCISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $582 | $7K | 11.64% |
| ACRISURE LLC3 Filed as: ACISURE OF CALIFORNIA LLC | 2055 WOODSIDE ROAD, SUITE 290 REDWOOD CITY, CA 94061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $151 | $151 | 0.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3000 EXECUTIVE PARKWAY, SUITE 300 SAN RAMON, CA 94583 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 10.70% |
| UNKNOWN3 | UNKNOWN SAN RAMON, CA 94583 | FIDELITY SECURITY LIFE INSURANCE | $809 | $0 | $809 | 15.00% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 115 | $1.8M |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 113 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $64K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $64K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $64K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 115 | $1.8M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.