| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 401 FREMONT STREET, SUITE 100 MONTEREY, CA 93940 | SUTTER HEALTH PLAN | $72K | $0 | $72K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $60K | $0 | $60K | 4.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $2K | $2K | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, IL 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $55K | $14K | $69K | 14.87% |
| 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 | $13K | $13K | 2.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 1319 RIVERSIDE, CA 92501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.43% |
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 | 436 | 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) | 436 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 270 | $2.8M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 436 | $461K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 436 | $461K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 436 | $461K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 436 | $461K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 436 | $461K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 270 | $2.8M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 436 | $461K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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.