| 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 | $68K | — | $68K | 4.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | — | $586 | $586 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 91102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | $157 | $15K | 9.88% |
| IMA, INC.3 Filed as: IMA INC. | 8200 E 32ND ST. N WICHITA, KS 67226 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 1.54% |
| IMA, INC.3 Filed as: IMA INC. | 1705 17TH ST. SUITE 100 DENVER, CO 80202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $172 | — | $172 | 0.11% |
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 | 235 | 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) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 217 | $1.4M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 228 | $155K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 228 | $155K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 228 | $155K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 217 | $1.4M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 228 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.