| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCES INC | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $103K | $3K | $106K | 3.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $2K | $19K | 11.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | DELTA DENTAL OF CALIFORNIA | $11K | $0 | $11K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | DELTA DENTAL OF CALIFORNIA | $11K | $0 | $11K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS, SVCES | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN CA | $0 | $129 | $129 | 0.16% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | LEGAL SHIELD | $873 | $0 | $873 | 12.38% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4695 MACARTHUR COURT NEWPORT BEACH, CA 92660 | LEGAL SHIELD | $745 | $0 | $745 | 10.57% |
| LYNN R LIONHOOD4 | 10935 BARBS WAY ORLAND PARK, IL 60467 | LEGAL SHIELD | $38 | $0 | $38 | 0.54% |
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 | 182 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 497 | $3.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 332 | $322K |
| Vision | BLUE CROSS OF CALIFORNIA | 497 | $3.0M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 497 | $3.1M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 182 | $164K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 182 | $164K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 497 | $3.2M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 497 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 497 | — |
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."
No prospect flags tripped on this filing.