| 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 | $101K | $0 | $101K | 4.54% |
| 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 | $11K | $0 | $11K | 7.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.72% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $25K | $0 | $25K | 20.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $9K | $22K | 17.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | DENTAL HEALTH SERVICES | $3K | $0 | $3K | 11.80% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $855 | $0 | $855 | 13.28% |
| JEFFERY P RABBETTS3 Filed as: JEFFERY P. RABBETTS | 19240 BOX CANYON ROAD CORONA, CA 92881 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $121 | $0 | $121 | 1.88% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI & ASSOCIATES INS. SVCS. | 3400 WEST MINERAL KING AVENUE SUITE B VISALIA, CA 93291 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $120 | $0 | $120 | 1.86% |
| BRIAN EDWARD JUND3 | 99 WOOD AVENUE SOUTH SUITE 501 ISELINE, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $41 | $0 | $41 | 0.64% |
| THERESA M VAUGHN3 Filed as: THERESA MARIE VAUGHN | PO BOX 255 NORCO, CA 92860 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $35 | $0 | $35 | 0.54% |
| RICHARD BLAINE HUBER3 | PO BOX 501623 SAN DIEGO, CA 92150 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | $0 | $15 | 0.23% |
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 | 296 | 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) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 420 | $2.2M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 343 | $174K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 343 | $145K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 343 | $270K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $126K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $126K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 420 | $2.2M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 343 | $277K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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.