| 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 | $89K | $19K | $107K | 5.93% |
| MARSH & MCLENNAN AGENCY LLC3 | 3625 N. ELM ST. SUITE 200 GREENSBORO, NC 27455 | BLUE CROSS OF CALIFORNIA | $15 | $79 | $94 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $33K | $1 | $33K | 3.28% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN INC. | $336 | $3K | $4K | 0.36% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 3.60% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $640 | — | $640 | 1.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $212 | — | $212 | 0.65% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $842 | — | $842 | 2.80% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTERE SUITE 500 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $463 | — | $463 | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $211 | $2K | 11.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $174 | $2K | 11.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $171 | $2K | 11.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | FEDERAL INSURANCE COMPANY | $383 | — | $383 | 15.01% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: BARNEY & BARNEY A MARSH & | MCLENNAN AGENCY LLC CO. P.O. BOX 85638 SAN DIEGO, CA 92186 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $155 | — | $155 | 9.80% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG | 13102 BRITTANY WOODS DR. TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $98 | — | $98 | 6.19% |
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 | 415 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 421 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 465 | $2.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 465 | $1.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 465 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 465 | $1.8M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 33 | $14K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 21 | $31K |
| Other(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 735 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 735 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.