| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 925013315 | UNITEDHEALTHCARE INSURANCE COMPANY | $445K | — | $445K | 2.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $44K | — | $44K | 5.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $213K | $13K | $227K | 29.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $112K | $6K | $118K | 15.38% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $862 | $527 | $1K | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS IN | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | -$9 | $1K | 0.16% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $834 | — | $834 | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS IN | 40 E ALAMAR AVE SANTA BARBARA, CA 93105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $291 | — | $291 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | $9K | $40K | 13.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $3K | $10K | 14.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 925013315 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 12.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 5.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 925013315 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $289 | — | $289 | 12.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $115 | $115 | 4.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS IN | 40 E ALAMAR AVE SANTA BARBARA, CA 93105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$345 | — | -$345 | — |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$647 | — | -$647 | — |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFITS PROGRAMS AN AON CO | 1 N WHITE HORSE PIKE #2 HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$602 | -$119 | -$721 | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$2K | -$338 | -$2K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$4K | — | -$4K | — |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$13K | -$918 | -$14K | — |
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 | 2,403 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,020 | $19.7M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 2,020 | $18.9M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 2,020 | $18.9M |
| Life insurance(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,298 | $1.2M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,273 | $770K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,020 | $19.7M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,298 | $377K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,298 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.