| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | — | $59K | $59K | 3.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | — | $29K | $29K | 1.72% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 3.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 1.73% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | HUMANA INSURANCE COMPANY | $14K | — | $14K | 6.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | HUMANA INSURANCE COMPANY | $6K | — | $6K | 2.72% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 7979 OLD GEORGETWOWN ROAD SUITE 300 BETHESDA, MD 20814 | HUMANA INSURANCE COMPANY | -$134 | — | -$134 | -0.06% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $504 | $4K | 7.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.23% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $323 | $3K | 7.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.45% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $387 | $3K | 7.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.27% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | KAISER FOUNATION HEALTH PLAN INC | $1K | — | $1K | 3.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNATION HEALTH PLAN INC | $645 | — | $645 | 1.66% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $286 | $2K | 7.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.29% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $3K | $4K | 21.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $577 | — | $577 | 3.28% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $3K | $4K | 22.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $517 | — | $517 | 3.20% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $4K | 33.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $815 | — | $815 | 6.61% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | HUMANADENTAL INSURANCE COMPANY | $337 | — | $337 | 6.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | HUMANADENTAL INSURANCE COMPANY | $175 | — | $175 | 3.42% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | COMPBENEFITS COMPANY | $95 | — | $95 | 6.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | COMPBENEFITS COMPANY | $5 | — | $5 | 0.36% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 7979 OLD GEORGETWOWN ROAD SUITE 300 BETHESDA, MD 20814 | DENTICARE, INC. | -$5 | — | -$5 | — |
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 | 380 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 320 | $2.2M |
| Dental(4 contracts, 4 carriers) | HUMANA INSURANCE COMPANY | 229 | $213K |
| Vision | HUMANA INSURANCE COMPANY | 229 | $206K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $80K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 74 | $44K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 349 | $43K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 320 | $1.7M |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.