| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $84K | $0 | $84K | 5.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN RIVERSIDE, CA 92507 | RIVERSTONE CAPITAL LLC | $23K | $0 | $23K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 437 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | DELTA DENTAL OF CALIFORNIA | $15K | $0 | $15K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | STANDARD INSURANCE COMPANY | $8K | $4K | $11K | 9.44% |
| ROBERT D AHEARN3 | 13646 MORNINGSIDE DRIVE YUCAIPA, CA 92399 | AFLAC | $9K | $263 | $10K | 14.27% |
| MARIAN E LENCIONI3 | 1109 WEST 9TH STREET UPLAND, CA 91786 | AFLAC | $1K | $79 | $2K | 2.31% |
| SHANE CRAIG DAVISON AND VARIOUS AGE3 | 120 PROVIDENCE TRAIL APT 1200 MOUNT JULIET, TN 37122 | AFLAC | $1K | $76 | $1K | 1.93% |
| DAVID J REESOR3 | 2220 EAST ROUTE 66 SUITE 215 GLENDORA, CA 91740 | AFLAC | $856 | $0 | $856 | 1.28% |
| AARON D MCGOVERN3 | 1794 AVENIDA REGINA SAN MARCOS, CA 92069 | AFLAC | $585 | $79 | $664 | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2393 TOWNSGATE ROAD SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $272 | $0 | $272 | 0.41% |
| MARK J FITZGERALD3 | 3004 NORTH ROAD RUNNER COURT HIGHLAND, CA 92346 | AFLAC | $234 | $0 | $234 | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | EYEMED VISION CARE | $3K | $0 | $3K | 8.39% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 319 | $2.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 518 | $217K |
| Vision | EYEMED VISION CARE | 460 | $35K |
| Life insurance | STANDARD INSURANCE COMPANY | 307 | $119K |
| Short-term disability | STANDARD INSURANCE COMPANY | 307 | $119K |
| Long-term disability | STANDARD INSURANCE COMPANY | 307 | $119K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 319 | $2.0M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 307 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 518 | — |
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.