| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $13 | $249K | $249K | 2.98% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA PHYSICIANS SERVICE | $6 | $117K | $117K | 1.40% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $35K | — | $35K | 6.00% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $27K | $867 | $28K | 16.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $11K | $21K | 13.47% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 3.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $10K | $19K | 13.35% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 3.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY, SUITE 300 RIVERSIDE, CA 92501 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $12K | — | $12K | 8.30% |
| ENROLLEASE3 Filed as: ONE DIGITAL | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | — | $4K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $8K | $16K | 13.22% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 3.36% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 6.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $6K | — | $6K | 10.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 6.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL CULVER CITY | 600 CORPORATE POINTE WALK SUITE 600 CULVER CITY, CA 90230 | MAGELLAN HEALTH | $1K | — | $1K | 10.00% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G AUFDEMBERG INC. | 13102 BRITTANY WOODS DR TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $584 | — | $584 | 8.89% |
| SANDRA SIMS4 Filed as: SANDRA ALLEN | 501 AGUA PLACE SEAL BEACH, CA 90740 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $85 | — | $85 | 1.29% |
| JOHN P. LONDONO4 | 4621 N LEAVITT ST APT 3 CHICAGO, IL 60625 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $66 | — | $66 | 1.00% |
| LONDONO MILLER BENEFITS INC4 | 28326 ATLEY COURT SAUGUS, CA 91350 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $64 | — | $64 | 0.97% |
| AMY EVANS4 | 1751 COLORADO BLVD LOS ANEGELES, CA 90041 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $25 | — | $25 | 0.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL-CENTER DR | 3390 UNIVERSITY, SUITE 300 RIVERSIDE, CA 92501 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $59 | — | $59 | 6.24% |
| ENROLLEASE3 Filed as: ONE DIGITAL | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $28 | — | $28 | 2.96% |
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 | 860 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 889 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 1,499 | $8.4M |
| Dental(4 contracts) | DELTA DENTAL OF CALIFORNIA | 1,137 | $766K |
| Vision(2 contracts) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,598 | $145K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 860 | $277K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,165 | $144K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 1,499 | $8.4M |
| Other(5 contracts, 4 carriers) | AFLAC | 860 | $469K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,598 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.