| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $232K | $13K | $244K | 4.22% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | UNKNOWN BURBANK, CA 91505 | DELTA DENTAL OF CALIFORNIA | $16K | — | $16K | 3.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 5405 MOREHOUSE DRIVE, SUITE 340 SAN DIEGO, CA 92121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33K | $13K | $46K | 13.95% |
| AMY EVANS3 | 14358 MAGNOLIA BOULEVARD APARTMENT 103 SHERMAN OAKS, CA 91423 | AFLAC | $3K | — | $3K | 3.60% |
| MJ INSURANCE3 Filed as: ALFRED RIETKERK AND VARIOUS AGENTS | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $3K | — | $3K | 2.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2393 TOWNGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $2K | — | $2K | 2.66% |
| NASHINA BUSH3 | 16161 VENTURA BOULEVARD SUITE 421 ENCINO, CA 91436 | AFLAC | $2K | — | $2K | 1.87% |
| RICHARD J KUNZ3 Filed as: RICHARD J. KUNZ | 351 CALIFORNIA STREET, SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $1K | — | $1K | 1.51% |
| RENEE SUZANNE CORSO3 | 5805 SEPULVEDA BOULEVARD SUITE 740 SHERMAN OAKS, CA 91411 | AFLAC | $733 | — | $733 | 0.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2029 CENTURY PARK EAST, SUITE 210 LOS ANGELES, CA 90067 | AFLAC | $659 | — | $659 | 0.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | EYEMED | $8K | — | $8K | 10.82% |
| UNKNOWN3 | UNKNOWN BURBANK, CA 91505 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $791 | — | $791 | 5.00% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $336 | — | $336 | 7.06% |
| SANDRA SIMS4 Filed as: SANDRA ALLEN | 501 AGUA PLACE SEAL BEACH, CA 90740 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $130 | — | $130 | 2.73% |
| AMY EVANS4 | 5805 SEPULVEDA BOULEVARD SHERMAN OAKS, CA 91411 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $46 | — | $46 | 0.97% |
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 | 742 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 742 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 1,045 | $5.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 940 | $446K |
| Vision | EYEMED | 1,114 | $78K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 742 | $329K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 742 | $329K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 742 | $329K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 1,045 | $5.8M |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 742 | $441K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,114 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.