| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $159K | — | $159K | 3.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | SUTTER HEALTH PLAN | $37K | — | $37K | 4.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $109 | $14K | 3.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $109 | $8K | 21.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC. | $4K | — | $4K | 11.04% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $263 | — | $263 | 1.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $219 | — | $219 | 0.85% |
| MICHAEL KEITH MCDONOUGH3 | 1100 PACIFIC MARINA ALAMEDA, CA 94501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | — | $208 | 0.81% |
| DIANE MARIE SOMMERS3 | 1100 PACIFIC MARINA ALAMEDA, CA 94501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $191 | — | $191 | 0.74% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | — | $128 | 0.50% |
| ESTRADA ENTERPRISES LLC3 | 5340 EDGEVIEW DRIVE DISCOVEERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.46% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH STREET SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.16% |
| MICHAEL KIRKPATRICK3 | P.O. BOX 270 FREEDOM, CA 95050 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.08% |
| ABRAMS MARKETING INC3 Filed as: ABRAMS MARKETING INC. | 9538 W. PICO BLVD. LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.05% |
| THE AGURS GROUP INC.4 | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $51 | — | $51 | 6.20% |
| KATHLEEN R. GONZALES4 | 5721 FRENCH LACE COURT LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $25 | — | $25 | 3.04% |
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 | 471 | 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) | 471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 462 | $5.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 657 | $403K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 657 | $367K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 657 | $393K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 18 | $26K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 462 | $5.1M |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 657 | $430K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 657 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.