| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $90K | $0 | $90K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $38K | $1K | $40K | 4.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | UNKNOWN NORTH HOLLYWOOD, CA 91607 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 5.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 9595 WILSHIRE BOULEVARD, SUITE 801 BEVERLY HILLS, CA 90212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $6K | $15K | 16.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.28% |
| KRISTEN NICOLE GLENN3 | 1604 VIA TULIPAN SAN CLEMENTE, CA 92673 | AFLAC | $1K | $120 | $1K | 8.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 5405 MOREHOUSE DRIVE SAN DIEGO, CA 92121 | AFLAC | $282 | $0 | $282 | 1.69% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A REYNOSO & VARIOUS AGENT | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $190 | $24 | $214 | 1.29% |
| MIRIAM F HUNGERFORD3 | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $204 | $0 | $204 | 1.23% |
| PEGGY K SALMON3 | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $109 | $0 | $109 | 0.65% |
| DENISE M. AVILA WALKER3 Filed as: DENISE AVILA WALKER | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $42 | $24 | $66 | 0.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $60 | $0 | $60 | 0.36% |
| ANGEL L. STEPHENS3 Filed as: ANGEL L STEPHENS | PO BOX 36114 LOS ANGELES, CA 90036 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $219 | $0 | $219 | 6.78% |
| IBRAHIM ABDELHADI3 | 3600 GREYSTONE DRIVE APARTMENT 716 AUSTIN, TX 78731 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $154 | $0 | $154 | 4.77% |
| JERRY K. COHEN3 Filed as: JERRY K COHEN | 15720 VENTURA BOULEVARD SUITE 324 ENCINO, CA 91436 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $47 | $0 | $47 | 1.45% |
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 | 248 | 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) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 272 | $2.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 340 | $254K |
| Vision | VISION SERVICE PLAN | 242 | $36K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $89K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $89K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 272 | $2.7M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.