| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVC INC | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $36K | — | $36K | 2.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVC INC | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | — | $18K | 1.07% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $20 | — | $20 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVC INC | 4371 LATHAM ST. SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | — | $44K | $44K | 2.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | STANDARD INSURANCE COMPANY | $20K | — | $20K | 9.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 401 BROADHOLLOW RD STE 200 MELVILLE, NY 11747 | STANDARD INSURANCE COMPANY | — | $6K | $6K | 2.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | STANDARD INSURANCE COMPANY | $17K | — | $17K | 14.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 401 BROADHOLLOW RD STE 200 MELVILLE, NY 11747 | STANDARD INSURANCE COMPANY | — | $5K | $5K | 4.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 13.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 401 BROADHOLLOW RD STE 200 MELVILLE, NY 11747 | STANDARD INSURANCE COMPANY | — | $3K | $3K | 4.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 9.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 401 BROADHOLLOW RD STE 200 MELVILLE, NY 11747 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 2.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 9.83% |
| BENEFIT EDUCATORS LLC3 Filed as: BENEFIT EDUCATORS, LLC | 1053 GARRISON LN SOUDERTON, PA 18964 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 401 BROADHOLLOW RD STE 200 MELVILLE, NY 11747 | STANDARD INSURANCE COMPANY | — | $975 | $975 | 2.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 3390 UNIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC | $1K | — | $1K | 11.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 13.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 401 BROADHOLLOW RD STE 200 MELVILLE, NY 11747 | STANDARD INSURANCE COMPANY | — | $517 | $517 | 4.27% |
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 | 283 | 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) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 245 | $3.2M |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 210 | $236K |
| Vision | STANDARD INSURANCE COMPANY | 474 | $48K |
| Life insurance | STANDARD INSURANCE COMPANY | 262 | $118K |
| Short-term disability | STANDARD INSURANCE COMPANY | 48 | $12K |
| Long-term disability | STANDARD INSURANCE COMPANY | 277 | $55K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 245 | $3.2M |
| Other(3 contracts) | STANDARD INSURANCE COMPANY | 277 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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.