| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 1091 NORTH SHORELINE BOULEVARD SUITE 200 MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $5K | $33K | 4.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92501 | UNION SECURITY INSURANCE COMPANY | $9K | $6K | $15K | 12.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3 EMVARCADERO CENTER, SUITE 560 SAN FRANCISCO, CA 94111 | UNION SECURITY INSURANCE COMPANY | $6K | $175 | $6K | 4.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3 EMVARCADERO CENTER, SUITE 560 SAN FRANCISCO, CA 94111 | UDC DENTAL OF CALIFORNIA, INC. | $2K | $43 | $2K | 14.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92501 | UDC DENTAL OF CALIFORNIA, INC. | — | $403 | $403 | 3.04% |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 96 | $667K |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 255 | $135K |
| Vision | UNION SECURITY INSURANCE COMPANY | 255 | $122K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 255 | $122K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 255 | $122K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 96 | $667K |
| Other | UNION SECURITY INSURANCE COMPANY | 255 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.