| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | BLUE CROSS OF CALIFORNIA | $46K | $7K | $53K | 4.80% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SVCS., INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $0 | $18K | $18K | 1.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.30% |
| MJ INSURANCE3 Filed as: DANIEL B. COLE & VARIOUS AGENTS | 1632 CHRISTINA COURT PASO ROBLES, CA 93466 | AFLAC | $2K | $0 | $2K | 2.13% |
| TERRY L. IAVICOLI3 | 220 RUTH ANN WAY ARROYO GRANDE, CA 93420 | AFLAC | $959 | $0 | $959 | 1.08% |
| DAWN T SUCHECKI3 Filed as: DAWN M. TYACK | 582 CAMINO MERCADO ARROYO GRANDE, CA 93420 | AFLAC | $959 | $0 | $959 | 1.08% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS CONSULTANTS | 10653 WEST LEILANI DRIVE BOISE, ID 83709 | AFLAC | $536 | $0 | $536 | 0.60% |
| DANIEL VORDALE INS SVCS INC3 Filed as: DANIEL VORDALE INS. SVCS., INC. | 712 MERCURY AVENUE LOMPOC, CA 93436 | AFLAC | $331 | $0 | $331 | 0.37% |
| MICHAEL W. ATTERBERRY3 Filed as: MICHAEL JOHN LIZALDE | 1955 MINDA DRIVE EUGENE, OR 97401 | AFLAC | $287 | $0 | $287 | 0.32% |
| COLE & COLE INS SVCS LLC3 Filed as: COLE & COLE INS. SVCS., INC. | 5558 CALIFORNIA AVENUE, SUITE 320 BAKERSFIELD, CA 93309 | AFLAC | $282 | $0 | $282 | 0.32% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 208 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $129K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 258 | $1.2M |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $218K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 208 | $1.1M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.