| 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 | $79K | $4K | $83K | 2.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $36K | — | $36K | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $41K | $1 | $41K | 3.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 6.98% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNEY CENTRE SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $97 | — | $97 | 0.41% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $668 | — | $668 | 3.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE SUITE 500 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $340 | — | $340 | 1.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $266 | $2K | 12.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $244 | $2K | 12.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $229 | $2K | 12.11% |
| 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 | $67 | — | $67 | 8.96% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG | 13102 BRITTANY WOODS DR. TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $60 | — | $60 | 8.02% |
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 | 466 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 470 | $4.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 470 | $3.0M |
| Vision | BLUE CROSS OF CALIFORNIA | 470 | $3.0M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 470 | $3.0M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 34 | $17K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 31 | $38K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 470 | $4.4M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 470 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 470 | — |
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."
No prospect flags tripped on this filing.