| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $113K | $4K | $117K | 5.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | $0 | $15K | 8.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 7220 REDLANDS, CA 92375 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.34% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 9.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6510 SOUTH MILLROCK DRIVE SUITE 275 SALT LAKE CITY, UT 84121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 6.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 5.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | DENTAL HEALTH SERVICES | $4K | $0 | $4K | 13.00% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 20.12% |
| JEFFERY P RABBETTS3 Filed as: JEFFERY P. RABBETTS | 19240 BOX CANYON ROAD CORONA, CA 92881 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $196 | $0 | $196 | 2.33% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI & ASSOCIATES INS. SVCS. | 3400 WEST MINERAL KING AVENUE SUITE B VISALIA, CA 93291 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $182 | $0 | $182 | 2.16% |
| JUND BRIAN EDWARD3 | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $136 | $0 | $136 | 1.62% |
| THERESA M VAUGHN3 Filed as: THERESA MARIE VAUGHN | PO BOX 255 NORCO, CA 92860 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $65 | $0 | $65 | 0.77% |
| RICHARD BLAINE HUBER3 | PO BOX 501623 SAN DIEGO, CA 92150 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | $0 | $18 | 0.21% |
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 | 275 | 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) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 410 | $2.3M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $211K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $183K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $306K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $123K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $123K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 410 | $2.3M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $314K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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.