| 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 | CALIFORNIA PHYSICIANS SERVICE | $90K | $0 | $90K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $38K | $1K | $39K | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN NORTH HOLLYWOOD, CA 91607 | DELTA DENTAL OF CALIFORNIA | $13K | $0 | $13K | 5.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 9595 WILSHIRE BOULEVARD, SUITE 801 BEVERLY HILLS, CA 90212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 17.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.39% |
| KRISTEN NICOLE GLENN3 Filed as: KRISTEN GLENN | 1604 VIA TULIPAN SAN CLEMENTE, CA 92673 | AFLAC | $2K | $0 | $2K | 9.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 5405 MOREHOUSE DRIVE SAN DIEGO, CA 92121 | AFLAC | $627 | $0 | $627 | 3.42% |
| DENISE M. AVILA WALKER3 Filed as: DENISE AVILA WALKER | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $262 | $0 | $262 | 1.43% |
| MIRIAM HUNGERFORD3 | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $205 | $0 | $205 | 1.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT AND VARIOUS AGENT | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $184 | $0 | $184 | 1.00% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $169 | $0 | $169 | 0.92% |
| PEGGY K SALMON3 Filed as: PEGGY SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $109 | $0 | $109 | 0.59% |
| ANGEL L. STEPHENS4 | PO BOX 36114 LOS ANGELES, CA 90036 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $296 | $0 | $296 | 8.77% |
| IBRAHIM ABDELHADI4 | 4510 WEST GUADALUPE STREET APARTMENT C412 AUSTIN, TX 78751 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $168 | $0 | $168 | 4.98% |
| JERRY K. COHEN4 | 15720 VENTURA BOULEVARD, SUITE 324 ENCINO, CA 91436 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $51 | $0 | $51 | 1.51% |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 282 | $2.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 350 | $249K |
| Vision | VISION SERVICE PLAN | 238 | $35K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 246 | $85K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 246 | $85K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 282 | $2.6M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 246 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.