| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $90K | $735 | $91K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | $332 | $6K | 3.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | $77 | $2K | 3.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $174 | $4K | 10.46% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $178 | $4K | 10.49% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $51 | $1K | 10.48% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $424 | $424 | 4.00% |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $2.3M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $2.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $37K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $36K |
| Prescription drug(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $2.5M |
| Other(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 160 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.