| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $244K | — | $244K | 3.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLANS INC. | $180K | $10K | $190K | 3.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | SIMNSA | $46K | — | $46K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | STANDARD INSURANCE COMPANY | $11K | — | $11K | 4.48% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $47K | $3K | $50K | 20.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 5.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | VISION SERVICE PLAN | $3K | — | $3K | 2.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | CONCERN EAP | $2K | — | $2K | 5.00% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $3K | — | $3K | 21.98% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON RD., SUITE 100 SAN DIEGO, CA 92121 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $651 | — | $651 | 5.17% |
| MARK A. JONES4 | 10671 POINTE MOUNTAIN TOP, APT. 86 SPRING VALLEY, CA 91978 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $98 | — | $98 | 0.78% |
| MARIA SCHWARTZ4 | 312 VIA PROMESA SAN CLEMENTE, CA 92673 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $51 | — | $51 | 0.40% |
| DAVID PAPERNO4 | 78347 GRAPE ARBOR AVE PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $12 | — | $12 | 0.10% |
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 | 1,531 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,541 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,105 | $12.1M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 784 | $6.9M |
| Vision | VISION SERVICE PLAN | 747 | $101K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,531 | $492K |
| Short-term disability | AFLAC | 275 | $238K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,531 | $158K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,105 | $12.1M |
| Other(2 contracts, 2 carriers) | CONCERN EAP | 1,671 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,671 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.