| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | INSURANCE SERVICES PO BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN INC | $51K | $2K | $53K | 3.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 4371 LATHAM ST SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | — | $52K | $52K | 3.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $27K | — | $27K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON 12TH FL CHICAGO, IL 606049300 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 0.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. P O BOX 4047 CONCORD, CA 94524 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $15K | $4K | $19K | 12.02% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST #200 IRVINE, CA 92614 | UNNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $374 | $6K | 10.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | SERVICES INC STE 300 3390 UNIVERSITY AVE RIVERSIDE, CA 92501 | UNNUM LIFE INSURANCE COMPANY OF AMERICA | — | $108 | $108 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON 12TH FL CHICAGO, IL 606049300 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $808 | $808 | 1.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON 12TH FL CHICAGO, IL 606049300 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $256 | $256 | 0.94% |
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 | 239 | 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) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 293 | $3.4M |
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 193 | $295K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 574 | $162K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 574 | $162K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 279 | $42K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 271 | $1.7M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 574 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 574 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.