| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92506 | HEALTH NET | $46K | — | $46K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $27K | — | $27K | 3.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $2K | $7K | 8.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $2K | — | $2K | 6.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | VISION SERVICE PLAN | $819 | — | $819 | 3.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $828 | $470 | $1K | 8.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 18.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $336 | $336 | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $307 | — | $307 | 18.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $10 | $10 | 0.60% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 137 | $2.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 173 | $97K |
| Vision | VISION SERVICE PLAN | 163 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 454 | $13K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 95 | $851K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 454 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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."
No prospect flags tripped on this filing.