| 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 | $157K | — | $157K | 2.01% |
| 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. | $108K | $16K | $125K | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | DELTA DENTAL OF CALIFORNIA | $22K | — | $22K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | DELTA DENTAL OF CALIFORNIA | $29K | — | $29K | 10.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51K | $4K | $55K | 20.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30K | $2K | $32K | 11.88% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 2.76% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.98% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $32K | $3K | $35K | 18.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $1K | $22K | 11.69% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 2.93% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $24 | $3K | 1.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | EYEMED VISION CARE | $13K | — | $13K | 6.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $3K | $19K | 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 | $5K | $1K | $6K | 11.62% |
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 | 1,430 | 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) | 1,434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 1,574 | $13.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 781 | $845K |
| Vision | EYEMED VISION CARE | 2,601 | $188K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,656 | $484K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,003 | $271K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 1,574 | $13.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,656 | $403K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,601 | — |
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.