| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $133K | — | $133K | 5.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CIGNA HEALTHCARE OF CALIFORNIA | $59K | — | $59K | 4.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | $621 | $11K | 3.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91102 | TH GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $7K | $30K | 23.50% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 N. MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | TH GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $235 | — | $235 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $18K | — | $18K | 15.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 1.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $746 | $746 | 1.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $573 | $573 | 1.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $438 | — | $438 | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $78 | $78 | 0.78% |
| BRIAN SANDERSON4 | 1503 N. GRAND OAKS AVENUE PASADENA, CA 91104 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $96 | — | $96 | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $72 | — | $72 | 2.45% |
| MARIA THERESA FISHER4 | 29C OWENS LANDING COURT PERRYVILLE, MD 21903 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $37 | — | $37 | 1.26% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $28 | — | $28 | 0.95% |
| MICHELLE SCHULMAN4 | 817 KETTERING CLOSE ANTIOCH, TN 37013 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $18 | — | $18 | 0.61% |
| DAVID PAPERNO4 | 78347 GRAPE ARBOR AVENUE PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $14 | — | $14 | 0.48% |
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 | 563 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 574 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 369 | $4.2M |
| Dental | TH GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 484 | $129K |
| Vision | TH GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 484 | $129K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 563 | $119K |
| Short-term disability(2 contracts, 2 carriers) | TH GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 484 | $196K |
| Long-term disability(2 contracts, 2 carriers) | TH GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 484 | $181K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 369 | $4.2M |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 563 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 563 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.