| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $117K | $9K | $126K | 4.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | -$1 | $2K | $2K | 0.06% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $37K | $20 | $37K | 3.51% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $251 | $2K | 11.25% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $227 | $2K | 11.25% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $949 | — | $949 | 5.63% |
| 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 | $58 | — | $58 | 0.34% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $207 | $2K | 11.25% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $504 | — | $504 | 3.33% |
| 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 | $243 | — | $243 | 1.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE STANDARD | $933 | — | $933 | 6.19% |
| 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 | $79 | — | $79 | 10.17% |
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 | 469 | 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) | 469 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 476 | $3.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 476 | $2.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 476 | $2.8M |
| Life insurance(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 476 | $2.8M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $17K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 26 | $38K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 476 | $3.8M |
| Other(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 476 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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.