| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 437 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $0 | $84K | $84K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $44K | $2 | $44K | 3.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 437 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITED CONCORDIA INSURANCE COMPANY | $14K | $0 | $14K | 9.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $5K | $0 | $5K | 9.23% |
| GLOBAL SHIELD INSURANCE AGENCY3 | 511 EAST 1ST STREET, SUITE H TUSTIN, CA 92780 | AFLAC | $2K | $0 | $2K | 3.91% |
| JASON DAVIS INSURANCE SERVICES INC3 Filed as: JASON DAVIS INSURANCE SERVICES, INC | 8260 EAST ELLERFORD STREET LONG BEACH, CA 90808 | AFLAC | $2K | $0 | $2K | 3.61% |
| NICHOLAS K. GREEN3 | 14811 SAN JOSE AVENUE PARAMOUNT, CA 90723 | AFLAC | $534 | $0 | $534 | 1.08% |
| CLAUDIA P BABA3 Filed as: CLAUDIA P. BABA | PO BOX 4831 ORANGE, CA 92863 | AFLAC | $223 | $0 | $223 | 0.45% |
| MJ INSURANCE3 Filed as: JARRETT J. PAHOA AND VARIOUS AGENTS | 4971 BORREGO DRIVE LA PALMA, CA 90623 | AFLAC | $219 | $0 | $219 | 0.44% |
| JOSE RICARDO VELEZ3 | 7627 ALLENGROVE STREET DOWNEY, CA 90240 | AFLAC | $149 | $0 | $149 | 0.30% |
| ANGELA ANTONIA MENDEZ3 | 1561 WEST 227TH STREET TORRANCE, CA 90501 | AFLAC | $121 | $0 | $121 | 0.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 437 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $4K | $0 | $4K | 10.57% |
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 | 461 | 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) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 322 | $2.9M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 315 | $173K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 520 | $51K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 461 | $126K |
| Short-term disability | AFLAC | 66 | $49K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 322 | $2.9M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 461 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 520 | — |
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.