| 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 | $144K | — | $144K | 1.93% |
| 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. | $147K | $16K | $164K | 2.20% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $223K | $22K | $245K | 40.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44K | $7K | $50K | 8.24% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.43% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | DELTA DENTAL OF CALIFORNIA | $23K | — | $23K | 4.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $157K | $20K | $177K | 34.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33K | $6K | $39K | 7.69% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $468 | $6K | 1.22% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | DELTA DENTAL OF CALIFORNIA | $31K | — | $31K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DR. WEST, SUITE 1500 LOS ANGELES, CA 90045 | EYEMED VISION CARE | $15K | — | $15K | 7.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $4K | $24K | 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 | 12.45% |
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 | 1,696 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,705 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 2,284 | $14.9M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 890 | $893K |
| Vision | EYEMED VISION CARE | 3,109 | $207K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,136 | $862K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,136 | $610K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 2,284 | $14.9M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,212 | $758K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,109 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.