| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD SUITE 202 WAUKESHA, WI 53188 | BLUE CROSS OF CALIFORNIA | $40K | — | $40K | 3.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SRVCS INC | PO BOX 2158 RIVERSIDE, CA 925162158 | BLUE CROSS OF CALIFORNIA | — | $4K | $4K | 0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SRVCS | 701 UNIVERSITY AVE STE 100 SACRAMENTO, CA 958256756 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 255387 SACRAMENTO, CA 95865 | NATIONWIDE | $14K | — | $14K | 14.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATINAL INS SRVCS INC | PO BOX 255387 SACRAMENTO, CA 95865 | AMERITAS | $11K | — | $11K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SRVS | 701 UNIVERSITY AVE STE 100 SACRAMENTO, CA 958256756 | KAISER FOUNDATION HEALTH PLAN INC. | $289 | — | $289 | 0.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 2560 PROFESSIONAL PKWY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $348 | $3K | 40.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SRVS INC | PO BOX 2158 RIVERSIDE, CA 92516 | ARAG INSURANCE COMPANY | $406 | — | $406 | 10.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SRVCS INC | PO BOX 255387 SACRAMENTO, CA 95865 | CRUM & FORSTER | $380 | — | $380 | 17.51% |
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 | 89 | 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) | 89 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 127 | $1.9M |
| Dental | AMERITAS | 190 | $73K |
| Vision(2 contracts, 2 carriers) | AMERITAS | 190 | $83K |
| Life insurance | NATIONWIDE | 128 | $96K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 10 | $7K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE | 128 | $96K |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 128 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.