| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $3K | $97K | $100K | 6.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $2K | $30K | 2.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $12K | $0 | $12K | 5.00% |
| GARY RANDY RIDER3 | UNKNOWN NORTHRIDGE, CA 91325 | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH | $7K | $0 | $7K | 15.00% |
| PAUL GALLEGOS3 | 10519 SHOSHONE AVENUE GRAND HILLS, CA 91344 | AFLAC | $1K | $0 | $1K | 4.06% |
| MJ INSURANCE3 Filed as: JOSEPH BUZZELLO AND VARIOUS AGENTS | 9018 BALBOA BOULEVARD, SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $789 | $0 | $789 | 2.34% |
| ALFRED RIETKERK3 | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $520 | $0 | $520 | 1.54% |
| PATRICK J FLYNN3 Filed as: PATRICK J. FLYNN | PO BOX 502127 SAN DIEGO, CA 92150 | AFLAC | $501 | $0 | $501 | 1.49% |
| CLAUDIA ORTEGA3 | 652 KATHERINE DRIVE MONTEBELLO, CA 90640 | AFLAC | $452 | $0 | $452 | 1.34% |
| MJ INSURANCE3 Filed as: CHARLES S. BOONE | 1252 GREENFIELD STREET THOUSAND OAKS, CA 91360 | AFLAC | $429 | $0 | $429 | 1.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2393 TOWNSGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $201 | $0 | $201 | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | 40 EAST ALAMAR AVENUE SANTA BARBARA, CA 93105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 14.69% |
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 | 355 | 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) | 355 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 236 | $3.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 484 | $249K |
| Vision | VISION SERVICE PLAN | 247 | $30K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH | 365 | $45K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 236 | $3.0M |
| Other(4 contracts, 4 carriers) | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH | 365 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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."
No prospect flags tripped on this filing.