| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | LLC 1600 W. HILLSDALE BLVD., SUITE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS' SERVICE | $27K | — | $27K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $18K | — | $18K | 1.32% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET FLOOR 6 SAN DIEGO, CA 92101 | CALIFORNIA PHYSICIANS' SERVICE | $9K | — | $9K | 0.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 1.16% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B. STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 0.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 3.44% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 18100 VON KARMAN AVENUE 10TH FLOOR IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 1.81% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | ATT. ERICA MENDEZ 701 B. STREET 6TH FL SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $3K | $8K | 6.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $136 | $4K | 3.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $116 | $8K | 7.38% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | ATT. ERICA MENDEZ 701 B ST. 6TH FL SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $744 | $5K | 4.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 3.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METLIFE LEGAL PLANS | $740 | $39 | $779 | 5.83% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BLVD. SUITE 400 WALNUT CREEK, CA 94596 | METLIFE LEGAL PLANS | $362 | — | $362 | 2.71% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | DB-EB OPERATING ACCOUNT P.O. BOX 8299 PASADENA, CA 91109 | METLIFE LEGAL PLANS | $230 | — | $230 | 1.72% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | METLIFE LEGAL PLANS | — | $102 | $102 | 0.76% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 3600 N. CAPITAL OF TEXAS HWY AUSTIN, TX 78746 | METLIFE LEGAL PLANS | — | $55 | $55 | 0.41% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 5444 WESTHEIMER RD. SUITE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | $738 | $189 | $927 | 7.51% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 5 RIVER PARK PLACE 3RD FLOOR FRESNO, CA 93720 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $218 | — | $218 | 15.00% |
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 | 386 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 199 | $1.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 423 | $129K |
| Vision | VISION SERVICE PLAN | 193 | $35K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 386 | $234K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 386 | $124K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 386 | $124K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 150 | $1.8M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 436 | $249K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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.