| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | KAISER FOUNDATION HEALTH PLAN INC. | $45K | $2K | $47K | 4.14% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP - NATIONAL ACCOUNT SERVICES | 7272 E. INDIAN SCHOOL RD., STE. 220 SCOTTSDALE, AZ 85251 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 24.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNION SECURITY INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UDC DENTAL OF CALIFORNIA, INC. | $829 | — | $829 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | EYEMED VISION CARE | $631 | — | $631 | 9.12% |
| MAXWELL HEALTH3 | 101 TREMONT STREET, 11TH FLOOR BOSTON, MA 02108 | EYEMED VISION CARE | $126 | — | $126 | 1.82% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 208 | $1.1M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 47 | $36K |
| Vision | EYEMED VISION CARE | 98 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $28K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $28K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 208 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.