| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $34K | — | $34K | 3.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $10K | — | $10K | 1.43% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $7K | — | $7K | 1.02% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | DELTA DENTAL OF CALIFORNIA | $7K | — | $7K | 9.99% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $560 | $6K | 11.66% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $71 | $71 | 0.14% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $197 | $3K | 16.12% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $24 | $24 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $1K | $3K | 18.63% |
| ENROLLEASE3 Filed as: ENROLLEASE INC. | 7979 OLD GEORGETOWN RD. SUITE 300 BETHESDA, MD 208142554 | METROPOLITAN LIFE INSURANCE COMPANY | — | $392 | $392 | 2.61% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD. SUITE 300 KIRKWOOD, MO 631224042 | METROPOLITAN LIFE INSURANCE COMPANY | $99 | $10 | $109 | 0.73% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD. SUITE 300 KIRKWOOD, MO 631224042 | METROPOLITAN LIFE INSURANCE COMPANY | — | $25 | $25 | 0.17% |
| POLENZANI BENEFITS & INSURANCE3 Filed as: POLENZANI BENEFITS & INSURANCE SVCS | 3452 E. FOOTHILL BLVD. SUITE 514 PASADENA, CA 91107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 18.45% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $126 | $227 | $353 | — |
| ENROLLEASE3 Filed as: ENROLLEASE INC. | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 891352958 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $25 | $25 | — |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 146 | $1.6M |
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 128 | $86K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 215 | $15K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $67K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $64K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 146 | $1.6M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.