| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | BLUE CROSS OF CALIFORNIA | $60K | $375 | $60K | 3.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD, SUITE 100 PASADENA, CA 94596 | BLUE CROSS OF CALIFORNIA | $29K | $2K | $31K | 1.85% |
| 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 | $9K | — | $9K | 3.74% |
| IMA, INC.3 | PO BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.84% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 13.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | STANDARD INSURANCE COMPANY | $614 | $547 | $1K | 2.88% |
| IMA, INC.3 | 1075 17TH STREET SUITE 100 DENVER, CO 80202 | STANDARD INSURANCE COMPANY | — | $259 | $259 | 0.64% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | $7 | $1K | 3.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $570 | $42 | $612 | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 10.31% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 269 | $1.9M |
| Dental | BLUE CROSS OF CALIFORNIA | 269 | $1.7M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 257 | $33K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 219 | $54K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 219 | $54K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 219 | $54K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 269 | $1.9M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 257 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.