| 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 | $896 | $52K | 2.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 4371 LATHAM ST SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | — | $53K | $53K | 3.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 3390 UNIVERSITY AVENUE SUITE #300 RIVERSIDE, CA 92501 | STANDARD INSURANCE COMPANY | $21K | — | $21K | 9.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 1378 CORVALLIS, OR 97339 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 3390 UNIVERSITY AVENUE SUITE #300 RIVERSIDE, CA 92501 | STANDARD LIFE INSURANCE COMPANY | $14K | — | $14K | 12.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 1378 CORVALLIS, OR 97339 | STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 4.77% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST #200 IRVINE, CA 92614 | UNNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $419 | $7K | 10.36% |
| 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 | 4.16% |
| 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 | — | $134 | $134 | 0.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 3390 UNIVERSITY AVENUE SUITE #300 RIVERSIDE, CA 92501 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 9.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 1378 CORVALLIS, OR 97339 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 2.54% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST #200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $153 | $3K | 7.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS, INC. | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 3390 UNIVERSITY AVENUE SUITE #300 RIVERSIDE, CA 92501 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 12.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 1378 CORVALLIS, OR 97339 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 3390 UNIVERSITY AVE, STE 300 RIVERSIDE, CA 92501 | METLIFE LEGAL PLANS | $1K | $141 | $2K | 11.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. PO BOX 2158 RIVERSIDE, CA 92516 | METLIFE LEGAL PLANS | — | $45 | $45 | 0.32% |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 266 | $3.5M |
| Dental | STANDARD INSURANCE COMPANY | 213 | $224K |
| Vision | STANDARD INSURANCE COMPANY | 467 | $54K |
| Life insurance(2 contracts, 2 carriers) | STANDARD LIFE INSURANCE COMPANY | 278 | $151K |
| Long-term disability | STANDARD INSURANCE COMPANY | 277 | $30K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 247 | $1.7M |
| Other(4 contracts, 4 carriers) | STANDARD LIFE INSURANCE COMPANY | 278 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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.