| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $51K | $5K | $56K | 6.76% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND | FINANCIAL SERVICES 12404 PARK CENTRAL DRIVE, SUITE 400 DALLAS, TX 75251 | BLUE CROSS OF CALIFORNIA | — | $8K | $8K | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $15 | — | $15 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 9.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $103 | $2K | 16.36% |
| DAILYFEATS INC.3 | 131 TREMONT STREET 3RD FLOOR BOSTON, MA 02111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $165 | — | $165 | 1.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 BRAND BLVD. SUITE 600 GLENDALE, CA 91203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 16.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $240 | — | $240 | 3.29% |
| ENROLLEASE3 Filed as: ENROLLEASE LLC | EASECENTRAL 1980 FESTIVAL PLAZA DRIVE, SUITE 33 LAS VEGAS, NV 89135 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $219 | — | $219 | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 W. GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $16 | $16 | 0.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $827 | $69 | $896 | 16.26% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 133 | $828K |
| Dental | BLUE CROSS OF CALIFORNIA | 133 | $828K |
| Vision | HUMANA INSURANCE COMPANY | 107 | $13K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 133 | $838K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 23 | $6K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 133 | $828K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 133 | $828K |
| Other(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 133 | $845K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.