| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICE | $5K | $55K | $60K | 5.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | — | $9K | $9K | 0.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | AMERITAS LIFE INSURANCE CORP. | $5K | — | $5K | 9.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 4250 EXECUTIVE SQUARE, SUITE 900 SAN DIEGO, CA 92037 | AMERITAS LIFE INSURANCE CORP. | $447 | $420 | $867 | 1.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | GERBER LIFE INSURANCE COMPANY | $3K | — | $3K | 8.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | GERBER LIFE INSURANCE COMPANY | $660 | — | $660 | 1.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 18.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $305 | $108 | $413 | 1.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $881 | — | $881 | 5.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $698 | — | $698 | 4.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 19.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $109 | $108 | $217 | 1.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 13.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $113 | — | $113 | 1.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $683 | $1K | $2K | 25.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $65 | $108 | $173 | 2.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $946 | — | $946 | 15.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED OF OMAHA LIFE INSURANCE COMPANY | -$5 | — | -$5 | -0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $841 | $1K | $2K | — |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $111 | $14 | $125 | — |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 166 | $1.2M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 173 | $66K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 173 | $84K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 225 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 55 | $12K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 166 | $1.2M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 225 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.