| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIF INSURANCE COMPANY | $3K | $3K | $6K | 17.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $94 | $0 | $94 | 0.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS. OF CA | PO BOX 255387 SACRAMENTO, CA 95865 | UNUM LIFE INSUANCE COMPANY OF AMERICA | $158 | $0 | $158 | 1.44% |
| ANDREINI & COMPANY3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | UNUM LIFE INSUANCE COMPANY OF AMERICA | $7 | $0 | $7 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | UNKNOWN COLMA, CA 94014 | DELTA DENTAL OF CALIFORNIA | $700 | $0 | $700 | 10.00% |
| ANDREINI & COMPANY3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $85 | $0 | $85 | 1.26% |
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 | 518 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 519 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 36 | $7K |
| Vision | VISION SERVICE PLAN | 173 | $11K |
| Life insurance | UNITED OF OMAHA LIF INSURANCE COMPANY | 515 | $35K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 24 | $7K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIF INSURANCE COMPANY | 515 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 515 | — |
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.