| 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 | $104K | $104K | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 548 WEST CROMWELL AVENUE SUITE 101 FRESNO, CA 93711 | PRINCIPAL LIFE INSURANCE COMPANY | $25K | $0 | $25K | 10.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $6K | $6K | 2.47% |
| BRENT Y TANAMACHI3 | 2288 KENT STREET SAN MATEO, CA 94403 | AFLAC | $46 | $0 | $46 | 4.10% |
| GEORGIANNA STOUT3 | 34 LAUREL GLEN TER SAN RAFAEL, CA 94903 | AFLAC | $33 | $0 | $33 | 2.94% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BOUELVARD, SUITE 400 BURLINGAME, CA 94010 | AFLAC | $24 | $0 | $24 | 2.14% |
| ANNA JANICE RUIZ3 | 2596 17TH AVENUE SAN FRANCISCO, CA 94116 | AFLAC | $9 | $0 | $9 | 0.80% |
| JEANETTE SCHAUB3 | 5717 OWENS DRIVE PLEASANTON, CA 94588 | AFLAC | $9 | $0 | $9 | 0.80% |
| ALLISON FARRIS WENDELBERGER3 Filed as: ALLISON F WENDELBERGER & OTHER AGEN | 207 SANTA FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $8 | $0 | $8 | 0.71% |
| REGINA E MARTINELLI3 | 3360 RIVER ROAD WINDSOR, CA 95492 | AFLAC | $6 | $0 | $6 | 0.53% |
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 | 204 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 123 | $3.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $232K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $232K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $232K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $232K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 123 | $3.1M |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $237K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
No prospect flags tripped on this filing.