| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $112 | $54K | $54K | 5.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $47 | $19K | 7.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $7K | $16K | 6.16% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS. CO. MEDICARE SUPPLEMENT | $20K | — | $20K | 14.12% |
| HUB INTERNATIONAL MIDWEST LIMITED5 Filed as: HUB INTERNATIONAL INS SERVICES INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED AMERICAN INS. CO. MEDICARE SUPPLEMENT | $5K | $0 | $5K | 3.53% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS INC | $10K | $0 | $10K | 9.26% |
| HUB INTERNATIONAL MIDWEST LIMITED5 Filed as: HUB INTERNATIONAL INS SERVICES INC. | PO BOX 2158 RIVERSIDE, CA 92516 | EXPRESS SCRIPTS INC | $1K | $0 | $1K | 1.03% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 205 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $258K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $258K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $258K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $258K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $258K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 205 | $1.2M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.