| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | KAISER FOUNDATION HEALTH PLAN, INC. | $70K | $0 | $70K | 5.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 255387 SACRAMENTO, CA 95865 | WESTERN HEALTH ADVANTAGE | $27K | $0 | $27K | 3.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 970 RESERVE DRIVE ROSEVILLE, CA 95678 | WESTERN HEALTH ADVANTAGE | $20K | $0 | $20K | 2.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | PROMINENCE HEALTH PLAN | $18K | $0 | $18K | 3.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 255387 SACRAMENTO, CA 95865 | SUTTER HEALTH PLAN | $21K | $0 | $21K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SE | PO BOX 803 LOS ALAMOS, CA 93440 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $42K | $11K | $53K | 14.03% |
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 | 358 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 182 | $3.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $375K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $375K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $375K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $375K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 182 | $3.0M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $375K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.