| 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 | BLUE CROSS OF CALIFORNIA | $110K | $2K | $112K | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $17K | — | $17K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3635 RIVERSIDE PLAZA DR BLDG M3 STE 320 RIVERSIDE, CA 92506 | HEALTHIESTYOU C/O TELADOC HEALTH INC | $6K | — | $6K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 11.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 14.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $898 | — | $898 | 3.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 18.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $837 | $2K | 12.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $522 | — | $522 | 3.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $686 | $3K | 18.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $910 | — | $910 | 6.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $448 | $2K | 18.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $616 | — | $616 | 6.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN GENERAL INSURANCE COMPANY | $786 | $46 | $832 | 9.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $50 | $50 | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 2000 S. COLORADO BLVD TOWER 2 SUITE 150 DENVER, CO 80222 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $14 | $14 | 0.17% |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 284 | $2.3M |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 394 | $172K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 394 | $172K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $60K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 207 | $16K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 284 | $2.2M |
| Other(7 contracts, 3 carriers) | HEALTHIESTYOU C/O TELADOC HEALTH INC | 216 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.