| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN, INC | $16K | $0 | $16K | 3.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2158 RIVERSIDE, CA 92516 | SUTTER HEALTH PLAN | $17K | $0 | $17K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $8K | 14.59% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BOULEVARD, SUITE 400 BURLINGAME, CA 94010 | AFLAC | $332 | $23 | $355 | 8.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 456 MONTGOMERY STREET, SUITE 1600 SAN FRANCISCO, CA 94104 | AFLAC | $326 | $0 | $326 | 7.41% |
| GARY K. ANDERSON3 Filed as: GARY K ANDERSON AND OTHER AGENTS | 72 MONTE VISTA ROAD FAIRFAX, CA 94930 | AFLAC | $82 | $40 | $122 | 2.77% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: MATTHEW DOMINIC BROWN | 490 43RD STREET, SUITE 1009 OAKLAND, CA 94609 | AFLAC | $97 | $9 | $106 | 2.41% |
| GABRIEL LUCAS3 | 218 7TH AVENUE, APARTMENT 105 SAN MATEO, CA 94401 | AFLAC | $103 | $0 | $103 | 2.34% |
| GEORGIANNA STOUT3 | 34 LAUREL GLEN TER SAN RAFAEL, CA 94903 | AFLAC | $54 | $0 | $54 | 1.23% |
| MARC LAMPELL3 | 448 IGNACIO BOULEVARD, SUITE 470 NOVATO, CA 94949 | AFLAC | $42 | $0 | $42 | 0.95% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP INC | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES | $281 | $0 | $281 | 6.80% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL INSURANCE | FLOOR 4, 600 CORPORATE POINTEE CULVER CITY, CA 90230 | PRE-PAID LEGAL SERVICES | $140 | $0 | $140 | 3.39% |
| CRAIG PETERSEN4 | PMB 163, 550 WEST PIONEER BOULEVARD SUITE 140 MESQUITE, NV 89027 | PRE-PAID LEGAL SERVICES | $21 | $0 | $21 | 0.51% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 60 | $735K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $58K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $58K |
| Short-term disability | AFLAC | 8 | $4K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $58K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.