| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | BLUE CROSS OF CALIFORNIA | $106K | $22K | $128K | 6.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $7K | $2K | $9K | 6.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | MEDIEXCEL HEALTH PLAN | $3K | — | $3K | 4.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 16.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 14.74% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 1350 CAMINO DEL RIO STE 207 SAN DIEGO, CA 92108 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $491 | $24 | $515 | 7.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $144 | $10 | $154 | 2.35% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3130 CROW CANYON PL, STE 400 SAN RAMON, CA 94583 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 1.01% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 1350 CAMINO DEL RIO STE 207 SAN DIEGO, CA 92108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $301 | $22 | $323 | 13.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $111 | $9 | $120 | 5.11% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3130 CROW CANYON PL, STE 400 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.72% |
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 | 293 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 186 | $2.1M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 195 | $138K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 195 | $138K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 293 | $43K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 50 | $7K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $20K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 186 | $2.1M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 293 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.