| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | HEALTH NET | $163K | — | $163K | 1.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | KAISER FOUNDATION HEALTH PLAN INC. | $63K | $10K | $73K | 2.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | DELTA DENTAL OF CALIFORNIA | $19K | — | $19K | 4.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | DELTA DENTAL OF CALIFORNIA | $27K | — | $27K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $725 | $14K | 6.53% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 5.57% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 2.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | EYEMED VISION CARE | $11K | — | $11K | 6.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $3K | $18K | 12.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $467 | $10K | 7.78% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 6.20% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $789 | $5K | 12.33% |
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 | 1,417 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,421 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 1,143 | $11.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 764 | $711K |
| Vision | EYEMED VISION CARE | 2,527 | $170K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,496 | $394K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 642 | $209K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 1,143 | $11.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,496 | $318K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,527 | — |
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."
No prospect flags tripped on this filing.