| 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 SUITE 300 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $63 | $110K | $110K | 5.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $50K | $1K | $51K | 5.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 5.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 5.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.30% |
| KRISTEN NICOLE GLENN3 | 1604 VIA TULIPAN SAN CLEMENTE, CA 92673 | AFLAC | $1K | $86 | $1K | 8.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 5405 MOREHOUSE DRIVE SAN DIEGO, CA 92121 | AFLAC | $473 | $0 | $473 | 2.72% |
| SHERRY VANDERVOORT AND OTHER AGENTS3 | 203 CALLE SONORA SAN CLEMENTE, CA 92672 | AFLAC | $245 | $0 | $245 | 1.41% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $170 | $0 | $170 | 0.98% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $151 | $17 | $168 | 0.97% |
| DENISE M. AVILA WALKER3 | 2605 DELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $145 | $17 | $162 | 0.93% |
| PEGGY K SALMON3 Filed as: PEGGY K. SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $84 | $0 | $84 | 0.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | ARAG INSURANCE COMPANY | $300 | $0 | $300 | 9.12% |
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 | 254 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 302 | $3.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 460 | $259K |
| Vision | VISION SERVICE PLAN | 253 | $40K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $96K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $96K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 302 | $3.1M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 460 | — |
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.