| 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 | $31K | $0 | $31K | 4.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $970 | $970 | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | WESTERN HEALTH ADVANTAGE | $10K | $0 | $10K | 4.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN SACRAMENTO, CA 95841 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 10.49% |
| 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 | $9K | $0 | $9K | 16.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON, 12TH FLOOR CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $844 | $0 | $844 | 6.00% |
| RICHARD E. DUMONT INC4 | PO BOX 929 NEWCASTLE, CA 95658 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $153 | $0 | $153 | 6.66% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE ROAD ONE PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $109 | $0 | $109 | 4.75% |
| LUCKSON EMMANUEL4 | 1667 PALATIA DRIVE ROSEVILLE, CA 95661 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $51 | $0 | $51 | 2.22% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 59 | $831K |
| Dental | DELTA DENTAL OF CALIFORNIA | 144 | $73K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 136 | $14K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $57K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $57K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $57K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 59 | $831K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.