| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN IRVINE, CA 92612 | CIGNA HEALTHCARE OF CALIFORNIA | $26K | — | $26K | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 19800 MACARTHUR BLVD. SUITE 1250 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 0.38% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40K | $5K | $45K | 10.61% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1 | $3K | 2.49% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $13 | $1K | 1.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $2 | $1K | 1.01% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $6 | $1K | 1.36% |
| DALE ALLEN NICHOLS3 | 728 LEGENDS CREST DRIVE FRANKLIN, TN 37069 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $833 | — | $833 | 1.03% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST 1ST STREET SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $764 | — | $764 | 0.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 40 REDLANDS, CA 92373 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $554 | — | $554 | 0.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $330 | — | $330 | 0.41% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.03% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | HYATT LEGAL PLANS | $2K | $17 | $2K | 11.84% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HYATT LEGAL PLANS | — | $217 | $217 | 1.65% |
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 | 1,454 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 2,328 | $9.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,328 | $1.0M |
| Vision | EYEMED VISION CARE | 2,521 | $113K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,454 | $426K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,454 | $426K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,454 | $426K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 2,328 | $9.1M |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,945 | $656K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,945 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.