| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA | $45K | $3K | $47K | 3.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $44K | $3 | $44K | 3.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3633 EAST BROADWAY, SUITE 200 LONG BEACH, CA 90803 | STANDARD INSURANCE COMPANY | $49K | $9K | $58K | 13.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3633 EAST BROADWAY, SUITE 200 LONG BEACH, CA 90803 | STANDARD INSURANCE COMPANY | $8K | $796 | $9K | 42.09% |
| BENEFIT EDUCATORS LLC3 Filed as: BENEFIT EDUCATORS, LLC | 1053 GARRISON LANE SOUDERTON, PA 18964 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 25.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $2K | $0 | $2K | 12.07% |
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 | 252 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 262 | $3.0M |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 489 | $435K |
| Vision | STANDARD INSURANCE COMPANY | 489 | $422K |
| Life insurance | STANDARD INSURANCE COMPANY | 489 | $422K |
| Short-term disability | STANDARD INSURANCE COMPANY | 489 | $422K |
| Long-term disability | STANDARD INSURANCE COMPANY | 489 | $422K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 262 | $3.0M |
| Other(2 contracts) | STANDARD INSURANCE COMPANY | 489 | $443K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 489 | — |
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.