| 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 | $176K | $99 | $176K | 4.61% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 S. PARKET ST. 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | — | $88K | $88K | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $6K | $33K | 9.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $14K | 7.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS 721 S. PARKET ST., SUITE 300 ORANGE, CA 92868 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 5.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | EYEMED | $4K | — | $4K | 6.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $4K | $1K | $5K | 9.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $541 | $7K | 17.46% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS 721 S. PARKET ST., SUITE 300 ORANGE, CA 92868 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.37% |
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 | 548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 899 | $3.8M |
| Dental(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 899 | $4.2M |
| Vision(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 899 | $3.9M |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 606 | $223K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 606 | $183K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 606 | $183K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 899 | $3.8M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 606 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 899 | — |
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.