| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $0 | $244K | $244K | 3.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | $0 | $23K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | UNKNOWN ONTARIO, CA 91761 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 4.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | UNKNOWN ONTARIO, CA 91761 | DELTA DENTAL OF CALIFORNIA | $5K | $0 | $5K | 9.16% |
| BRANDON TYLOR-DA SHIRLEY3 Filed as: BRANDON TYLOR DAVID SHIRLEY | 5110 SOUTH SHERBOURN DRIVE LOS ANGELES, CA 90056 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 10.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 7.39% |
| CHARLES N. CRAVINGS JR3 Filed as: CHARLES NATHANIEL CRAVINGS JR | 1467 WEST 49TH STREET LOS ANGELES, CA 90062 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 3.49% |
| CARLOS DAVID HERNANDEZ3 | 4736 WEST 136TH STREET HAWTHRONE, CA 90250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 3.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $4K | $0 | $4K | 10.00% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HEMDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $1K | $0 | $1K | 5.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 3390 UNIVERSITY RIVERSIDE, CA 92501 | LIFESECURE INSURANCE COMPANY | $381 | $0 | $381 | 1.87% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $260 | $0 | $260 | 1.28% |
| DAVID HILLELSOHN3 Filed as: DAVID HILLESOHN | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $119 | $0 | $119 | 0.58% |
| AON CONSULTING INC3 | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $67 | $0 | $67 | 0.33% |
| CAPITOL METRO FINANCIAL SERVICES3 | 7230 LEE DEFOREST DRIVE COLUMBIA, MD 21046 | LIFESECURE INSURANCE COMPANY | $62 | $0 | $62 | 0.30% |
| TELLUS BROKERAGE CONNECTIONS3 | 4135 NORTH FRONT STREET HARRISBURGH, PA 17110 | LIFESECURE INSURANCE COMPANY | $23 | $0 | $23 | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $846 | $0 | $846 | 8.08% |
| CAP STEWART4 | 5701 WALDEN WOODS COURT KNOXVILLE, TN 37921 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $494 | $0 | $494 | 4.72% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $139 | $0 | $139 | 1.33% |
| TERESA M. DAVILA4 Filed as: TERESA M DAVILA | 2964 AINA LANI DRIVE MAKAWAO, HI 96768 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $41 | $0 | $41 | 0.39% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: MARSH AND MCLENNAN AGENCY LLC | 755 WEST BIG BEAVER ROAD SUITE 2300 TROY, MI 48084 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $27 | $0 | $27 | 0.26% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HEMDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $121 | $0 | $121 | 6.18% |
| DAVID HILLELSOHN3 Filed as: DAVID HILLESOHN | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $43 | $0 | $43 | 2.20% |
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 | 252 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 598 | $6.4M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 314 | $231K |
| Vision | VISION SERVICE PLAN | 247 | $43K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $228K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $228K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $228K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 598 | $6.4M |
| Other(5 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $310K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 598 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.