| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED5 Filed as: HUB INTERNATIONAL OF CA INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | — | $57 | $57 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MVI ADMINISTRATORS INC EIN 33-0393692 NONE | Plan Administrator Service code 14 | — | $43K |
| HUB INTERNATIONAL INS. SVCS., INC. EIN 36-4412416 NONE | Insurance brokerage commissions and fees Service code 53 | — | $42K |
| COAST BENEFITS, INC. EIN 33-0670046 NONE | Plan Administrator Service code 14 | — | $40K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| MELISSA W COOK & ASSOCIATES EIN 95-3245809 NONE | Legal Service code 29 | — | $11K |
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 | 732 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 732 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 167 | $1.7M |
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INS CO | 343 | $222K |
| Vision | THE LINCOLN NATIONAL LIFE INS CO | 402 | $56K |
| Life insurance | THE LINCOLN NATIONAL LIFE INS CO | 667 | $17K |
| Other | THE LINCOLN NATIONAL LIFE INS CO | 667 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 667 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.