| 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 | $238K | $243K | 5.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $25K | $0 | $25K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $8K | $8K | 3.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN ONTARIO, CA 91761 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 6.31% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $1K | $0 | $1K | 4.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 3390 UNIVERSITY RIVERSIDE, CA 92501 | LIFESECURE INSURANCE COMPANY | $596 | $0 | $596 | 2.32% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $373 | $0 | $373 | 1.45% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $347 | $0 | $347 | 1.35% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $258 | $0 | $258 | 1.01% |
| CAPITOL METRO FINANCIAL SERVICES3 | 7230 LEE DEFOREST DRIVE COLUMBIA, MD 21046 | LIFESECURE INSURANCE COMPANY | $76 | $0 | $76 | 0.30% |
| TELLUS BROKERAGE CONNECTIONS3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $41 | $0 | $41 | 0.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| DAVID HERNANDEZ3 Filed as: DAVID HERNANDEZ AND OTHER AGENTS | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $552 | $0 | $552 | 4.45% |
| JAMES P BOADA3 Filed as: JAMES P. BOADA | 32741 POINTE STIRLING, SUITE 12G DANA POINT, CA 92629 | AFLAC | $297 | $0 | $297 | 2.39% |
| JEFFREY C. BOYKINS3 | PO BOX 2917 WINNETKA, CA 91396 | AFLAC | $188 | $0 | $188 | 1.51% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $130 | $0 | $130 | 1.05% |
| ABEL A. DELUNA3 | 1270 WEST 39TH STREET, APT 5 LOS ANGELES, CA 90037 | AFLAC | $125 | $0 | $125 | 1.01% |
| TAMI FUKUSHIMA3 | PO BOX 3757 BEVERLY HILLS, CA 90212 | AFLAC | $117 | $0 | $117 | 0.94% |
| CHARLES N. CRAVINGS JR3 | 1467 WEST 49TH STREET LOS ANGELES, CA 90062 | AFLAC | $115 | $0 | $115 | 0.93% |
| 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 | 8.40% |
| CAP STEWART4 | 5701 WALDEN WOODS COURT KNOXVILLE, TN 37921 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $401 | $0 | $401 | 4.35% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $154 | $0 | $154 | 1.67% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: MARSH AND MCLENNAN AGENCY LLC | 755 WEST BIG BEAVER ROAD SUITE 2300 TROY, MI 48084 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $27 | $0 | $27 | 0.29% |
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 | 235 | 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) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 559 | $4.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 566 | $214K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 559 | $4.5M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 235 | $271K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 235 | $246K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 235 | $246K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 13 | $95K |
| Other(5 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 235 | $319K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 566 | — |
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.