| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $55K | — | $55K | 4.92% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 1.95% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | — | $15K | $15K | 2.11% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $22K | $958 | $23K | 16.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | HUMANA, INC. | $6K | — | $6K | 4.69% |
| HAMMAN MILLER BEAUCHAMP DEEBLE3 | 660 YORK STREET SAN FRANCISCO, CA 94110 | HUMANA, INC. | $1K | — | $1K | 1.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3633 E. BROADWAY LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| JOHN KUNZ3 | 5805 SEPULVEDA BLVD. SHERMAN OAKS, CA 91411 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $850 | — | $850 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3633 E. BROADWAY LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $750 | — | $750 | 11.00% |
| JOHN KUNZ3 | 5805 SEPULVEDA BLVD. SHERMAN OAKS, CA 91411 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $341 | — | $341 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE CULVER CITY, CA 90230 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 21.13% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 112 | $1.8M |
| Dental | HUMANA, INC. | 113 | $117K |
| Vision | HUMANA, INC. | 113 | $117K |
| Life insurance(3 contracts, 2 carriers) | AFLAC | 174 | $166K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 119 | $147K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 112 | $1.8M |
| Other(3 contracts, 3 carriers) | AFLAC | 174 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.