| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $21K | — | $21K | 3.47% |
| CIFS INC3 Filed as: CIFS INC. | 3435 WILSHIRE BLVD. SUITE 3000 LOS ANGELES, CA 90010 | BLUE CROSS OF CALIFORNIA | $15K | — | $15K | 2.44% |
| THOMAS M. NIAL3 | 232 91 VENTURA BLVD. WOODLAND HILLS, CA 91364 | BLUE CROSS OF CALIFORNIA | $18 | — | $18 | 0.00% |
| ROBERT RASMUSSEN JR.3 | 23291 VENTURA BLVD. WOODLAND HILLS, CA 91364 | BLUE CROSS OF CALIFORNIA | $8 | — | $8 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | — | $2K | 1.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 4371 LATHAM ST., SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $1K | — | $1K | 1.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | STARMOUNT LIFE INSURANCE COMPANY | $2K | $527 | $3K | 8.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES 3435 WILSHIRE BLVD., SUTIE 3000 LOS ANGELES, CA 90010 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $199 | $1K | 3.89% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 137 | $733K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 33 | $31K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 33 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.