| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $2K | $55K | $57K | 5.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $333 | $333 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 548 WEST CROMWELL AVENUE SUITE 101 FRESNO, CA 93711 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $45 | $4K | 2.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 548 WEST CROMWELL AVENUE SUITE 101 FRESNO, NY 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 16.87% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY, INC. | 350 5TH AVENUE, SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| BRENT Y TANAMACHI3 Filed as: BRENT Y. TANAMACHI | 2288 KENT STREET SAN MATEO, CA 94403 | AFLAC | $46 | $0 | $46 | 4.13% |
| GEORGIANNA STOUT3 | 150 HARBOR DRIVE, SUITE 370 SAUSALITO, CA 94966 | AFLAC | $34 | $0 | $34 | 3.05% |
| BALTOR INSURANCE SERVICES3 | 11 AIRPORT BOULEVARD, SUITE 105 SOUTH SAN FRANCISCO, CA 94080 | AFLAC | $23 | $0 | $23 | 2.07% |
| ANNA JANICE RUIZ3 | 2596 17TH AVENUE SAN FRANCISCO, CA 94116 | AFLAC | $8 | $0 | $8 | 0.72% |
| JEANETTE SCHAUB3 | 81 VINTAGE CIRCLE, SUITE 3247 PLEASANTON, CA 94566 | AFLAC | $8 | $0 | $8 | 0.72% |
| ALLISON FARRIS WENDELBERGER3 Filed as: ALLISON WENDELBERGER & OTHER AGENTS | 207 SANTA FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $8 | $0 | $8 | 0.72% |
| REGINA E MARTINELLI3 Filed as: REGINA E. MARTINELLI | 3360 RIVER ROAD WINDSOR, CA 95492 | AFLAC | $6 | $0 | $6 | 0.54% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 97 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $156K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 85 | $1.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $44K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $44K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 97 | $2.1M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.