| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | $107K | $9K | $116K | 6.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | MEDIEXCEL HEALTH PLAN | $3K | — | $3K | 1.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $7K | $538 | $7K | 6.20% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 1350 CAMINO DEL RIO STE 207 SAN DIEGO, CA 92108 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $175 | — | $175 | 3.50% |
| 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 | $53 | — | $53 | 1.06% |
| 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 | $22 | — | $22 | 0.44% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 3550 CAMINO DEL RIO STE 207 SAN DIEGO, CA 92108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15 | — | $15 | 3.94% |
| MARSH & MCLENNAN AGENCY LLC3 | ATTN ACCOUNTING SUTIE 1800 GREENSBORO, CA 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7 | — | $7 | 1.84% |
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 | 289 | 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) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 266 | $2.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 297 | $116K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 297 | $116K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 359 | $37K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 13 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 289 | $13K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 266 | $2.2M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 289 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 359 | — |
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.