| 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. | $119K | $5 | $119K | 4.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNAITONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $19K | $0 | $19K | 8.40% |
| 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 INTERNAITONAL INS. SVCS., INC. | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 9.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | DENTAL HEALTH SERVICES | $2K | $0 | $2K | 8.33% |
| PATRICK JOYCE3 | 17765 LADERA CIRCLE YORBA LINDA, CA 92886 | DENTAL HEALTH SERVICES | $681 | $0 | $681 | 2.50% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 16.43% |
| JEFFREY P. RABBETTS3 | 19240 BOX CANYON ROAD CORONA, CA 92881 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $128 | $0 | $128 | 1.96% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI AND ASSOCIATES INS. SVCS. | 3130 WEST MAIN STREET, SUITE 106 VISALIA, CA 93291 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $118 | $0 | $118 | 1.81% |
| BRIAN EDWARD JUND3 | 34 FALKNER DRIVE LADERA RANCH, CA 92694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $79 | $0 | $79 | 1.21% |
| THERESA M VAUGHN3 Filed as: THERESA MARIE VAUGHN | PO BOX 255 NORCO, CA 92860 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $41 | $0 | $41 | 0.63% |
| RICHARD BLAINE HUBER3 | 964 TINKER BELL AVENUE BIG BEAR, CA 92314 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 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. | 411 | $2.4M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $251K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $224K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $365K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $141K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $141K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 411 | $2.4M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $372K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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.