| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 5375 MIRA SORRENTO PLACE, SUITE 400 SAN DIEGO, CA 92121 | UNITED HEALTHCARE INSURANCE COMPANY | $112K | — | $112K | 4.51% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | — | $1K | $1K | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | UNITED CONCORDIA INSURANCE COMPANY | $21K | $19K | $40K | 17.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 16.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 2.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 12.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $282 | $4K | 11.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $359 | $2K | 9.84% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | P.O. BOX 100312 PASADENA, CA 91189 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $392 | — | $392 | 1.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 17.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $473 | $473 | 2.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 8.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $61 | $61 | 0.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $798 | $738 | $2K | 19.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $160 | — | $160 | 12.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | -$115 | -$113 | -8.67% |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 372 | $2.5M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 370 | $233K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 353 | $23K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $88K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $67K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $67K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 372 | $2.5M |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.