| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $3K | $3K | 0.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21K | $21K | $42K | 10.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 4.91% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $171 | $0 | $171 | 0.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES, INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $404 | $0 | $404 | 1.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $304 | $0 | $304 | 1.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $1K | $3K | 10.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $0 | $1K | 4.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3435 WILSHIRE BOULEVARD, SUITE 3000 LOS ANGELES, CA 90010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.85% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 5.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 3435 WILSHIRE BOULEVARD, SUITE 3000 LOS ANGELES, CA 90010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $647 | $0 | $647 | 2.80% |
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 | 723 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 741 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 303 | $2.0M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 454 | $119K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 705 | $407K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 705 | $407K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 303 | $2.0M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 705 | $455K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 705 | — |
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.