| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | PO BOX 6030 PASADENA, CA 91102 | UNITED HEALTHCARE INSURANCE COMPANY | $74K | $0 | $74K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 548 WEST CROMWELL AVENUE, SUITE 101 FRESNO, CA 93711 | UNITED HEALTHCARE INSURANCE COMPANY | $37K | $0 | $37K | 1.00% |
| IMA, INC.3 Filed as: IMA, INC | PO BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN, INC. | $31K | $0 | $31K | 1.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | $0 | $16K | 0.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 4.52% |
| CENTRO BENEFITS RESEARCH LLC3 | 24500 CHAGRIN BOULEVARD, SUITE 365 BEACHWOOD, OH 44122 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 2.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $459 | $459 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 4.62% |
| JOHN O BRONSON CO INC3 Filed as: JOHN O BRONSON CO | PO BOX 255387 SACRAMENTO, CA 95865 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 1.56% |
| IMA, INC.3 Filed as: IMA INC | PO BOX 102833 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $670 | $0 | $670 | 0.39% |
| UNKNOWN3 | UNKNOWN SACRAMENTO, CA 95811 | TELEDOC HEALTH | $5K | $0 | $5K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $359 | $2K | 6.74% |
| CENTRO BENEFITS RESEARCH LLC3 | 24500 CHAGRIN BOULEVARD, SUITE 365 BEACHWOOD, OH 44122 | METROPOLITAN LIFE INSURANCE COMPANY | $481 | $241 | $722 | 2.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | METROPOLITAN LIFE INSURANCE COMPANY | $487 | $0 | $487 | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $61 | $61 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 EAST FOOTHILLS BOULEVARD PASADENA, CA 91107 | MAGELLAN HEALTH SERVICES OF CALIFORNIA | $543 | $0 | $543 | 2.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | MAGELLAN HEALTH SERVICES OF CALIFORNIA | $394 | $0 | $394 | 2.10% |
| IMA, INC.3 Filed as: IMA, INC | 3475 EAST FOOTHILL BOULEVARD SUITE 100 PASADENA, CA 91107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $652 | $0 | $652 | 10.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 255387 SACRAMENTO, CA 95865 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $270 | $0 | $270 | 4.14% |
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 | 330 | 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) | 330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 152 | $5.6M |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 410 | $210K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 410 | $186K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 330 | $170K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 330 | $170K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 137 | $5.6M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 330 | $229K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.