| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | — | $6K | $6K | 0.25% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - ORANGE COUNTY | 17875 VON KARMEN IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $2K | $21K | 15.61% |
| 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 | $794 | — | $794 | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | STE 300 3390 UNIVERSITY AVE RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $106 | $106 | 0.08% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - ORANGE COUNTY | 17875 VON KARMEN IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $362 | $5K | 15.12% |
| 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 | $324 | — | $324 | 1.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | STE 300 3390 UNIVERSITY AVE RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $43 | $43 | 0.14% |
| 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 | $2K | $2K | $3K | 11.60% |
| 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 | $3K | — | $3K | 11.27% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | P.O. BOX 100312 PASADENA, CA 91189 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 6.54% |
| AON CONSULTING INC3 | 180 N STETSON AVENUE CHICAGO, IL 60601 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $778 | — | $778 | 3.45% |
| 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 | $720 | — | $720 | 4.54% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - ORANGE COUNTY | 17875 VON KARMAN IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $140 | — | $140 | 0.88% |
| 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 | — | $32 | $32 | 0.20% |
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 | 215 | 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) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 385 | $2.4M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 356 | $216K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 353 | $23K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 217 | $165K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 217 | $134K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 217 | $134K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 385 | $2.4M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 217 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 385 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.