| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $206K | $0 | $206K | 5.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $73K | $0 | $73K | 6.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $0 | $22K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOUELVARD 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 1.94% |
| ROBERT D AHEARN3 | 13646 MORNINGSIDE DRIVE YUCAIPA, CA 92399 | AFLAC | $8K | $339 | $9K | 8.91% |
| RENEE L WINGERT AND OTHER AGENTS3 | 23 DARLINGTON IRVINE, CA 92620 | AFLAC | $2K | $0 | $2K | 1.61% |
| MARIAN E LENCIONI3 | 30065 WILDWOOD PLACE SAND SPRINGS, OK 74063 | AFLAC | $1K | $0 | $1K | 1.31% |
| RANA JANE DENNIS3 | 9375 ARCHIBALD AVENUE, SUITE 302 RANCHO CUCAMONGA, CA 91730 | AFLAC | $569 | $12 | $581 | 0.60% |
| ARLICE C. MARSHALL3 Filed as: ARLICE C MARSHALL | 23709 BLACKBIRD CIRCLE MORENO VALLEY, CA 92557 | AFLAC | $461 | $54 | $515 | 0.53% |
| DAVID SMITH3 Filed as: DAVID MATTHEW SMITH | 2001 EAST FINANCIAL WAY, SUITE 200 GLENDORA, CA 91741 | AFLAC | $365 | $54 | $419 | 0.43% |
| DAVID J REESOR3 | 1615 WILSON AVENUE UPLAND, CA 91784 | AFLAC | $380 | $0 | $380 | 0.39% |
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 | 363 | 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) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 543 | $5.0M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 363 | $1.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 363 | $1.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 363 | $144K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 363 | $144K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 363 | $144K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 543 | $5.0M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 363 | $241K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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.