| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $139K | $0 | $139K | 4.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS IN | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14K | $0 | $14K | 7.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS | 3390 UNIVERSITY AVENUE. SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 NORTH CAUSEWAY BOULEVARD SUITE 200 METAIRIE, LA 70002 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $904 | $904 | 0.46% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $28K | $0 | $28K | 20.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $2K | $13K | 9.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $674 | $4K | 2.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA | PO BOX 2158 RIVERSIDE, CA 92504 | DENTAL HEALTH SERVICES | $2K | $0 | $2K | 8.33% |
| PATRICK JOYCE3 | 17765 LADERA CIRCLE YORBA LINDA, CA 92504 | DENTAL HEALTH SERVICES | $658 | $0 | $658 | 2.50% |
| HUBER RICHARD BLAINE3 | PO BOX 7220 REDLANDS, CA 92375 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 37.95% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI AND ASSOC INS SVCS | 3130 WEST MAIN STREET, SUITE 106 VISALIA, CA 93291 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $155 | $0 | $155 | 3.17% |
| RABBETTS JEFFERY P3 | 19240 BOX CANYON ROAD CORONA, CA 92881 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $57 | $0 | $57 | 1.17% |
| JUND BRIAN EDWARD3 Filed as: JUND BRAIN EDWARD | 34 FALKNER DR LADERA RANCH, CA 92694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $56 | $0 | $56 | 1.15% |
| VAUGHN THERESA MARIE3 | PO BOX 255 NORCO, CA 92860 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $32 | $0 | $32 | 0.65% |
| HUBER RICHARD BLAINE3 | 964 TINKER BELL AVENUE BUG BEAR, CA 92314 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | $0 | $12 | 0.25% |
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 | 451 | 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) | 451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 430 | $2.8M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 451 | $224K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 451 | $198K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 451 | $336K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $139K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $139K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 430 | $2.8M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 451 | $341K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.