| 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 | $5K | $203K | $208K | 5.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICE | UNKNOWN ONTARIO, CA 91761 | DELTA DENTAL OF CALIFORNIA | $13K | $0 | $13K | 6.45% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 325 CHESTNUT STREET, SUITE 1000 PHILADELPHIA, PA 19106 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 5.89% |
| PPI BENEFIT SOLUTIONS3 | 10 RESEARCH PARKWAY WALLINGFORD, CT 06492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $6K | $6K | 4.53% |
| MJ INSURANCE3 Filed as: DAVID HERNANDEZ & VARIOUS AGENTS | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $4K | $0 | $4K | 4.78% |
| JAMES P BOADA3 Filed as: JAMES P. BOADA | 25501 PURPLE SAGE LANE SAN JUAN CAPISTRANO, CA 92675 | AFLAC | $2K | $0 | $2K | 2.36% |
| ABEL A. DELUNA3 | 1270 WEST 39TH STREET, SUITE 5 LOS ANGELES, CA 90037 | AFLAC | $1K | $96 | $1K | 1.65% |
| JEFFREY C. BOYKINS3 | PO BOX 2917 WINNETKA, CA 91396 | AFLAC | $1K | $0 | $1K | 1.53% |
| CHARLES N. CRAVINGS JR3 | 1467 WEST 49TH STREET LOS ANGELES, CA 90062 | AFLAC | $804 | $22 | $826 | 1.08% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $796 | $0 | $796 | 1.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2393 TOWNSGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $787 | $0 | $787 | 1.03% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $963 | $0 | $963 | 3.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 9868 PLANO ROAD DALLAS, TX 75238 | LIFESECURE INSURANCE COMPANY | $611 | $0 | $611 | 2.46% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $506 | $0 | $506 | 2.04% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $398 | $0 | $398 | 1.60% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $297 | $0 | $297 | 1.20% |
| CAPITAL METRO FINANCIAL SERVICES3 Filed as: CAPITAL METRO FINANCIAL SERVICE | 7230 LEE DEFOREST DRIVE COLUMBUS, MD 21046 | LIFESECURE INSURANCE COMPANY | $91 | $0 | $91 | 0.37% |
| TELLUS BROKERAGE CONNECTIONS3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $41 | $0 | $41 | 0.17% |
| 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% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $955 | $0 | $955 | 8.66% |
| CAP STEWART4 | 5701 WALDEN WOODS COURT KNOXVILLE, TN 37921 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $416 | $0 | $416 | 3.77% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC | 13102 BRITTNAY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $203 | $0 | $203 | 1.84% |
| LYNDA BLANKENSHIP4 Filed as: LYNDA N BLANKENSHIP | 2442 WOODBINE AVENUE KNOXVILLE, TN 37917 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $193 | $0 | $193 | 1.75% |
| MARSH & MCLENNAN AGENCY LLC4 | 765 WEST BIG BEAVER ROAD SUITE 2300 TROY, MI 48084 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $44 | $0 | $44 | 0.40% |
| TERESA M. DAVILA4 | 2964 AINA LANI DRIVE MAKAWAO, HI 96768 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $33 | $0 | $33 | 0.30% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $113 | $0 | $113 | 6.30% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $81 | $0 | $81 | 4.52% |
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 | 226 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 541 | $4.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 546 | $198K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 541 | $3.9M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 229 | $155K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 226 | $132K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 226 | $132K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 14 | $86K |
| Other(6 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 229 | $269K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 546 | — |
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.