| 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 | $4K | $176K | $181K | 5.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | UNKNOWN ONTARIO, CA 91761 | DELTA DENTAL OF CALIFORNIA | $7K | $0 | $7K | 3.51% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $6K | $0 | $6K | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $4K | $25K | 12.91% |
| MJ INSURANCE3 Filed as: JACOB BURNS INC & VARIOUS AGENTS | 2905 MAGNOLIA AVENUE LONG BEACH, CA 90806 | AFLAC | $3K | $4 | $3K | 3.51% |
| JAMES P BOADA3 Filed as: JAMES P. BOADA | 25501 PURPLE SAGE LANE SAN JUAN CAPISTRANO, CA 92675 | AFLAC | $2K | $0 | $2K | 2.54% |
| JEFFREY C. BOYKINS3 | PO BOX 2917 WINNETKA, CA 91396 | AFLAC | $1K | $0 | $1K | 1.59% |
| ABEL A. DELUNA3 | 1270 WEST 39TH STREET, SUITE 5 LOS ANGELES, CA 90037 | AFLAC | $911 | $67 | $978 | 1.18% |
| TALHA ZAQUIR RAHMAN3 | 8811 ELDORADO PARKWAY, SUITE 4101 FRISCO, TX 75033 | AFLAC | $932 | $7 | $939 | 1.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2393 TOWNSGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $789 | — | $789 | 0.95% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $543 | $13 | $556 | 0.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $40 | $40 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE SHEILD OF CALIFORNIA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERMDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $766 | $0 | $766 | 3.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 9868 PLANO ROAD DALLAS, TX 75238 | LIFESECURE INSURANCE COMPANY | $501 | $0 | $501 | 2.49% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $398 | $0 | $398 | 1.98% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $353 | $0 | $353 | 1.76% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $223 | $0 | $223 | 1.11% |
| CAPITOL METRO FINANCIAL SERVICES3 | 7230 LEE DEFOREST DRIVE, SUITE 105 COLUMBIA, MD 21046 | LIFESECURE INSURANCE COMPANY | $84 | $0 | $84 | 0.42% |
| TELLUS BROKERAGE CONNECTIONS3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $31 | $0 | $31 | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $774 | $0 | $774 | 9.18% |
| CAP STEWART4 | 5701 WALDEN WOODS COURT KNOXVILLE, TN 37921 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $271 | $0 | $271 | 3.21% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G AUFDEMERG INC | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $172 | $0 | $172 | 2.04% |
| MARSH & MCLENNAN AGENCY LLC4 | 755 WEST BIG BEAVER ROAD SUITE 2300 TROY, MI 48084 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $27 | $0 | $27 | 0.32% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $113 | $0 | $113 | 4.60% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERMDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $81 | $0 | $81 | 3.30% |
| CRUMP LIFE INSURANCE SERVICES3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $73 | $0 | $73 | 2.97% |
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 | 212 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 533 | $3.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 304 | $193K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 533 | $3.4M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 212 | $212K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 212 | $192K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 212 | $192K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 13 | $74K |
| Other(6 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 212 | $326K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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.