| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC. | $55K | — | $55K | 5.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN INC. | $61 | — | $61 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | GUARDIAN | $10K | — | $10K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $10K | $172 | $10K | 21.62% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $204 | $5K | 16.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | EYEMED VISION CARE | $1K | — | $1K | 7.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | EYEMED VISION CARE | $490 | — | $490 | 2.82% |
| FLEXVISION - MD3 | 15400 CALHOUN DRIVE ROCKVILLE, MD 20855 | EYEMED VISION CARE | — | $273 | $273 | 1.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 174 | $988K |
| Dental | GUARDIAN | 190 | $96K |
| Vision | EYEMED VISION CARE | 174 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 267 | $41K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $50K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 174 | $988K |
| Other(6 contracts, 3 carriers) | AFLAC | 267 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.