| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS. INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $8K | $165K | $173K | 5.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $13K | $0 | $13K | 6.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $3K | $18K | 12.36% |
| MJ INSURANCE3 Filed as: JACOB BURNS INC. AND VARIOUS AGENTS | 2905 MAGNOLIA AVENUE LONG BEACH, CA 90806 | AFLAC | $3K | $81 | $3K | 3.75% |
| JAMES P BOADA3 Filed as: JAMES P. BOADA | 25501 PURPLE SAGE LANE SAN JUAN CAPISTRANO, CA 92675 | AFLAC | $2K | $0 | $2K | 2.64% |
| ABEL A. DELUNA3 | 1270 WEST 39TH STREET APARTMENT 5 LOS ANGELES, CA 90037 | AFLAC | $2K | $138 | $2K | 2.19% |
| JEFFREY C. BOYKINS3 | PO BOX 2917 WINNETKA, CA 91396 | AFLAC | $1K | $0 | $1K | 1.56% |
| TALHA ZAQUIR RAHMAN3 | 8811 ELDORADO PARKWAY APARTMENT 4101 FRISCO, TX 75033 | AFLAC | $1K | $75 | $1K | 1.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS. INC. | 2393 TOWNGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $977 | $0 | $977 | 1.08% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $639 | $43 | $682 | 0.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $125 | $125 | 0.14% |
| THE HASLETT MANAGEMENT GROUP3 | PO BOX 772697 OCALA, FL 34477 | LIFESECURE INSURANCE COMPANY | $954 | $0 | $954 | 3.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 9868 PLANO ROAD DALLAS, TX 75238 | LIFESECURE INSURANCE COMPANY | $612 | $0 | $612 | 2.30% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $511 | $0 | $511 | 1.92% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $431 | $0 | $431 | 1.62% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $272 | $0 | $272 | 1.02% |
| CAPITAL METRO FINANCIAL SERVICES3 | 7230 LEE DEFORST DRIVE COLUMBIA, MD 21046 | LIFESECURE INSURANCE COMPANY | $103 | $0 | $103 | 0.39% |
| TELLUS BROKERAGE CONNECTIONS3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $37 | $0 | $37 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 11.51% |
| CAP STEWART3 | 5701 WALDEN WOOD COURT KNOXVILLE, TN 37921 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $383 | $0 | $383 | 4.19% |
| CHRISTA G AUFDEMBERG INC3 Filed as: CHRISTA G. AUFDEMBERG | 13102 BRITTANY WOOD DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $204 | $0 | $204 | 2.23% |
| TERESA M. DAVILA3 | 2964 AINA LANI DRIVE MAKAWAO, HI 96768 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $98 | $0 | $98 | 1.07% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 755 WEST BIG BEAVER ROAD SUITE 2300 TROY, MI 48084 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $34 | $0 | $34 | 0.37% |
| CRUMP LIFE INSURANCE SERVICES3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $174 | $0 | $174 | 4.73% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $124 | $0 | $124 | 3.37% |
| THE HASLETT MANAGEMENT GROUP3 | PO BOX 772697 OCALA, FL 34477 | LIFESECURE INSURANCE COMPANY | $88 | $0 | $88 | 2.39% |
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 | 204 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 528 | $3.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 531 | $180K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 528 | $3.2M |
| Life insurance(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 528 | $3.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 204 | $142K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 204 | $142K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 13 | $89K |
| Other(6 contracts, 5 carriers) | CALIFORNIA PHYSICIANS SERVICE | 528 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 531 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.