| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $77K | $2K | $80K | 5.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.93% |
| RICHARD B HUBER3 Filed as: RICHARD B. HUBER | PO BOX 7220 REDLANDS, CA 92373 | THE LINCOLN NATIONAL INSURANCE COMPANY | $10K | — | $10K | 11.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL INSURANCE COMPANY | $9K | $270 | $10K | 10.29% |
| JEFFERY P RABBETTS3 Filed as: JEFFERY P. RABBETTS | 19240 BOX CANYON ROAD CORONA, CA 92881 | THE LINCOLN NATIONAL INSURANCE COMPANY | $6K | — | $6K | 7.00% |
| THERESA M VAUGHN3 Filed as: THERESA M. VAUGHN | PO BOX 255 NORCO, CA 92860 | THE LINCOLN NATIONAL INSURANCE COMPANY | $2K | — | $2K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $883 | $139 | $1K | 12.65% |
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 | 320 | 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) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 384 | $1.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $123K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $123K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL INSURANCE COMPANY | 273 | $101K |
| Short-term disability | THE LINCOLN NATIONAL INSURANCE COMPANY | 62 | $93K |
| Long-term disability | THE LINCOLN NATIONAL INSURANCE COMPANY | 62 | $93K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 384 | $1.6M |
| Other | AETNA LIFE INSURANCE COMPANY | 273 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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.