| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC. | $64K | $2K | $66K | 4.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | SHARP HEALTH PLAN | $27K | — | $27K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | DELTA DENTAL OF CALIFORNIA | $10K | — | $10K | 5.00% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $248 | $8K | 15.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $765 | $3K | 8.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $581 | $4K | 13.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | VISION SERVICE PLAN | $1K | — | $1K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | NATIONAL HEALTH INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $326 | $3K | 16.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | EMPATHIA PACIFIC, INC. | $495 | — | $495 | 8.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | ZURICH AMERICAN INSURANCE COMPANY | $317 | — | $317 | 20.01% |
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 | 232 | 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) | 232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 254 | $2.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 145 | $222K |
| Vision(2 contracts, 2 carriers) | SHARP HEALTH PLAN | 198 | $574K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 232 | $61K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 51 | $53K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 232 | $31K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 254 | $2.0M |
| Other(4 contracts, 4 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 260 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.