| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | — | — | $0 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 2 PARK PLZ STE 440 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | — | — | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC | — | $280 | $280 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 2.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | — | $45 | $45 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 548 W CROMWELL AVE STE 101 FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 13.31% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 548 W CROMWELL AVE STE 101 FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 14.40% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.32% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST UNIT 700 MINNEAPOLIS, MN 55402 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 548 W CROMWELL AVE STE 101 FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 6.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $12 | $12 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $45 | $4K | 16.69% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $70 | $1K | 5.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | — | $758 | $758 | 3.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $45 | $3K | 17.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $988 | $62 | $1K | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $654 | $654 | 3.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $45 | $3K | 17.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $723 | $45 | $768 | 5.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $509 | $509 | 3.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 548 W CROMWELL AVE STE 101 FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $664 | $664 | 4.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | ARAG INSURANCE COMPANY | $411 | — | $411 | 8.09% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 3697 MT., BLVD STE 100 LAFAYETTE, CA 94549 | ARAG INSURANCE COMPANY | $97 | — | $97 | 1.91% |
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 | 439 | 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) | 439 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 295 | $2.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 407 | $184K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 172 | $36K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 439 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $52K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 395 | $30K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 295 | $2.3M |
| Other(6 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 439 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 439 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.