| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN, INC. | $45K | $0 | $45K | 5.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | WESTERN HEALTH ADVANTAGE | $7K | $0 | $7K | 4.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN VACAVILLE, CA 95688 | DELTA DENTAL OF CALIFORNIA | $6K | $0 | $6K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 13.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.32% |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 159 | $976K |
| Dental | DELTA DENTAL OF CALIFORNIA | 201 | $62K |
| Vision | VISION SERVICE PLAN | 71 | $15K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 137 | $55K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 137 | $55K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 159 | $976K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 137 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.