| 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 | CALIFORNIA PHYSICIANS' SERVICE | $25K | $2K | $26K | 2.12% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | LLC 1600 W. HILLSDALE BLVD., SUITE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS' SERVICE | — | $25K | $25K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 2.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $7K | — | $7K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 12.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 4.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $2K | — | $2K | 4.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 91102 | METLIFE LEGAL PLANS | $1K | — | $1K | 10.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | METLIFE LEGAL PLANS | — | $27 | $27 | 0.22% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | DB-EB OPERATING ACCOUNT P.O. BOX 8299 PASADENA, CA 91109 | METLIFE LEGAL PLANS | $5 | — | $5 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $384 | $39 | $423 | 3.80% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS. SERVICES INC. | 5444 WESTHEIMER RD. SUITE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | $229 | $103 | $332 | 2.98% |
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 | 377 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 202 | $1.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 424 | $131K |
| Vision | VISION SERVICE PLAN | 193 | $36K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $211K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $101K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $101K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 144 | $1.7M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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.