| 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 | $57 | $159K | 4.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | SUTTER HEALTH PLAN | $47K | — | $47K | 4.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $5K | $14K | 3.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC. | $2K | $505 | $3K | 7.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $496 | $5K | 16.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | — | $174 | 0.90% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $151 | — | $151 | 0.78% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH STREET SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 0.41% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.36% |
| ESTRADA ENTERPRISES LLC3 | 5340 EDGEVIEW DRIVE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.36% |
| MICHAEL KIRKPATRICK3 | P.O. BOX 270 FREEDOM, CA 95019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.08% |
| ABRAMS MARKETING INC3 Filed as: ABRAMS MARKETING INC. | 9538 W. PICO BLVD. SUITE 204 LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.05% |
| THE AGURS GROUP INC.4 | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $406 | — | $406 | 15.80% |
| TANYA WEST MACKEY4 | 4328 PALMERO BLVD. LOS ANGELES, CA 90008 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $30 | — | $30 | 1.17% |
| KATHLEEN R. GONZALES4 | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $22 | — | $22 | 0.86% |
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 | 635 | 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) | 635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 417 | $4.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 836 | $439K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 836 | $401K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 836 | $420K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 14 | $19K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 417 | $4.7M |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 836 | $456K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 836 | — |
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."
No prospect flags tripped on this filing.