| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3 SUITE 320 RIVERSIDE, CA 92503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | $6K | $23K | 13.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN ONTARIO, CA 91761 | DELTA DENTAL OF CALIFORNIA | $12K | $0 | $12K | 7.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $193 | $193 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $15K | -$24 | $15K | 21.72% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $4K | $0 | $4K | 9.31% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $2K | $0 | $2K | 3.86% |
| CRUMP LIFE INSURANCE SERVICES3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $1K | $0 | $1K | 3.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 9868 PLANO ROAD DALLAS, TX 75238 | LIFESECURE INSURANCE COMPANY | $968 | $0 | $968 | 2.19% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $961 | $0 | $961 | 2.17% |
| CAPITOL METRO FINANCIAL SERVICES3 | 7230 LEE DEFOREST DRIVE COLUMBIA, MD 21046 | LIFESECURE INSURANCE COMPANY | $774 | $0 | $774 | 1.75% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $576 | $0 | $576 | 1.30% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4695 MACARTHUR COURT SUITE 600 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $618 | $0 | $618 | 10.10% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $290 | $0 | $290 | 4.74% |
| LYNN R LIONHOOD4 Filed as: LYNN R. LIONHOOD | 10935 BARBS WAY ORLAND PARK, IL 60467 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $35 | $0 | $35 | 0.57% |
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 | 188 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 19 | $106K |
| Dental | DELTA DENTAL OF CALIFORNIA | 362 | $161K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 523 | $67K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 523 | $237K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $170K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $170K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 19 | $106K |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 523 | $287K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 523 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.