| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | HEALTH NET | $78K | — | $78K | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | KAISER PERMANENTE | $65K | $1K | $67K | 3.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | UNITED CONCORDIA INSURANCE COMPANY | $9K | — | $9K | 2.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $1K | $15K | 10.89% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK | 2122 KRATKY ROAD ST. LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $1K | $15K | 10.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | SIMNSA HEALTH PLAN - MEXICAN HMO | $6K | — | $6K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $310 | $2K | $2K | 2.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | VISION SERVICE PLAN | $2K | — | $2K | 3.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $402 | — | $402 | 2.44% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $101 | $2K | 15.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | HEALTH AND HUMAN RESOURCES CENTER, INC. | $527 | — | $527 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | HYATT LEGAL PLANS, INC. | $909 | $49 | $958 | 10.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $150 | — | $150 | 15.00% |
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 | 549 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 549 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HEALTH NET | 482 | $5.7M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 428 | $358K |
| Vision | VISION SERVICE PLAN | 212 | $45K |
| Life insurance | STANDARD LIFE INSURANCE COMPANY | 561 | $111K |
| Short-term disability | AFLAC | 22 | $13K |
| Long-term disability | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 549 | $78K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 482 | $5.6M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 583 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 583 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.