| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INSURANCE | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $35K | — | $35K | 3.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | — | $3K | $3K | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | — | $293 | $293 | 0.03% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY STE 300 ATLANTA, GA 30339 | PRUDENTIAL | $6K | — | $6K | 5.24% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY STE 300 ATLANTA, GA 30339 | PRUDENTIAL | $557 | — | $557 | 0.50% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE STE 1100 CHICAGO, IL 60603 | PRUDENTIAL | — | $42 | $42 | 0.04% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 303393182 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 4.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 303393182 | DELTA DENTAL OF CALIFORNIA | $26 | — | $26 | 0.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 4371 LATHAM ST STE 101 RIVERSIDE, CA 92501 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $245 | — | $245 | 4.99% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 133 | $963K |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 102 | $98K |
| Vision | VISION SERVICE PLAN | 107 | $14K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL | 114 | $146K |
| Long-term disability | PRUDENTIAL | 114 | $112K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL | 114 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.