| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CALIFORNIA | $101K | $18K | $119K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN INC | $37K | — | $37K | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | DELTA DENTAL OF CALIFORNIA | $7K | — | $7K | 1.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 180 N RIVERVIEW DRIVE, SUITE 170 ANAHEIM, CA 92808 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 5.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 180 N RIVERVIEW DRIVE, SUITE 170 ANAHEIM, CA 92808 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 5.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2158 RIVERSIDE, CA 925162158 | VISION SERVICE PLAN | $2K | — | $2K | 1.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $1K | $5K | 6.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | DELTA DENTAL OF CALIFORNIA | $541 | — | $541 | 0.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 180 N RIVERVIEW DRIVE, SUITE 170 ANAHEIM, CA 92808 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.14% |
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 | 798 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 858 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CALIFORNIA | 2,000 | $10.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 1,237 | $736K |
| Vision | VISION SERVICE PLAN | 697 | $121K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 852 | $256K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 713 | $70K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 713 | $181K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CALIFORNIA | 993 | $10.0M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 798 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,000 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.