| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN INC. | $249K | $29 | $249K | 2.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | HEALTH NET | $128K | — | $128K | 1.99% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $155K | $11K | $166K | 19.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $47K | $4K | $51K | 6.06% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.19% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $944 | — | $944 | 0.11% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $103K | $8K | $112K | 15.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38K | $3K | $41K | 5.92% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $153 | $2K | 0.34% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $130 | — | $130 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | DELTA DENTAL OF CALIFORNIA | $28K | — | $28K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | DELTA DENTAL OF CALIFORNIA | $26K | — | $26K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMNITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $8K | $34K | 14.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | EYEMED VISION CARE | $17K | — | $17K | 7.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $3K | $9K | 13.91% |
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 | 1,989 | 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) | 1,998 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,837 | $18.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 813 | $959K |
| Vision | EYEMED VISION CARE | 3,231 | $218K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,421 | $1.2M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,421 | $848K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,837 | $18.0M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,531 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,231 | — |
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.