| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS SERVICE | $6K | $34K | $40K | 2.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $0 | $27K | $27K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4695 MACARTHUR COURT, SUIT 600 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC | $25K | $0 | $25K | 1.74% |
| LOCKTON COMPANIES, LLC3 | 725 FIGUEROA STREET, 35TH FLOOR LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $20K | $0 | $20K | 1.37% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 FIGUEROA STREET, 52ND FLOOR LOS ANGELES, CA 90017 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $73 | $7K | 5.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4695 MACARTHUR COURT, SUIT 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $54 | $6K | 3.98% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $416 | $416 | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 6.31% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 4.68% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.38% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 FIGUEROA STREET, 35TH FLOOR LOS ANGELES, CA 90017 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $3K | $0 | $3K | 5.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4695 MACARTHUR COURT, SUIT 600 NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $54 | $2K | 3.94% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $428 | $428 | 0.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $156 | $156 | 0.29% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.13% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.35% |
| BENEFIT TECHNOLOGIES LLC3 | 1200 EAST TAFT AVENUE SAPULPA, OK 74066 | TRUSTMARK INSURANCE COMPANY | $1K | $0 | $1K | 5.94% |
| US BENTEC WORKPLACE SOLUTIONS3 | 700 WEST HILLSBORO BOULEVARD BUILDING 2, SUITE 102 DEERFIELD BEACH, FL 33441 | TRUSTMARK INSURANCE COMPANY | $526 | $0 | $526 | 2.30% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 222 | $3.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $195K |
| Vision | VISION SERVICE PLAN | 389 | $48K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 389 | $104K |
| Short-term disability | TRUSTMARK INSURANCE COMPANY | 22 | $23K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 222 | $3.0M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 389 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.