| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | BLUE CROSS OF CALIFORNIA | $25K | $1K | $27K | 2.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $24K | — | $24K | 2.46% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $30K | — | $30K | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.33% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 3 PARKWAY NORTH SUITE 500 DEERFIELD, IL 60015 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $604 | $604 | 2.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 8.33% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $527 | — | $527 | 10.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $196 | — | $196 | 3.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $375 | — | $375 | 8.33% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | HOLMAN FAMILY COUNSELING, INC. | $214 | — | $214 | 4.99% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 77 | $1.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 156 | $95K |
| Vision | VISION SERVICE PLAN | 127 | $9K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $17K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 77 | $1.6M |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 131 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.