| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $26K | $0 | $26K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $1K | $1K | 0.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN NORTHRIDGE, CA 91325 | DELTA DENTAL OF CALIFORNIA | $9K | $0 | $9K | 5.00% |
| GARY RANDY RIDER3 | UNKNOWN NORTHRIDGE, CA 91325 | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH | $9K | $0 | $9K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 11.71% |
| 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 | $721 | $0 | $721 | 3.36% |
| BRANDON TYLOR-DA SHIRLEY3 Filed as: BRANDON TAYLOR-DAVID SHIRLEY | 5110 SOUTH SHERBOURNE DRIVE LOS ANGELES, CA 90056 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 12.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 11.61% |
| JEFFREY M SATTERLEE3 Filed as: JEFFREY MICHAEL SATTERLEE | 4351 JAGER DRIVE NE, SUITE J RIO RANCHO, NM 87144 | CONTINENTAL AMERICAN INSURANCE COMPANY | $315 | $0 | $315 | 2.47% |
| CARLOS DAVID HERNANDEZ3 | 4738 WEST 136TH STREET HAWTHORNE, CA 90250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $217 | $0 | $217 | 1.70% |
| CHRISTOPHER UNDERWOOD3 Filed as: CHRISTOPHER EVANS AND OTHER AGENTS | 5805 NORTH SEPULVEDA BOULEVARD SUITE 740 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $216 | $0 | $216 | 1.69% |
| RENEE SUZANNE CORSO3 | 2206 NORTH LAMER STREET BURBANK, CA 91504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $186 | $0 | $186 | 1.46% |
| AMY EVANS3 | 14358 MAGNOLIA BOULEVARD SUITE 103 SHERMAN OAKS, CA 91423 | CONTINENTAL AMERICAN INSURANCE COMPANY | $60 | $0 | $60 | 0.47% |
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 | 272 | 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) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 163 | $2.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 337 | $182K |
| Vision | VISION SERVICE PLAN | 204 | $26K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH | 275 | $61K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 163 | $2.5M |
| Other(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH | 275 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 337 | — |
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.