| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HEALTH NET | $23K | — | $23K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $43K | $378 | $44K | 5.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $7K | $25K | 10.50% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 S. 3RD ST., SUITE 800 COLUMBUS, OH 432155194 | METROPOLITAN LIFE INSURANCE COMPANY | -$10 | — | -$10 | -0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | — | $7K | 2.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $7K | — | $7K | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 911076024 | VISION SERVICE PLAN | $1K | — | $1K | 5.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $401 | $3K | 22.76% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 S. 3RD ST., SUITE 800 COLUMBUS, OH 43215 | METROPOLITAN LIFE INSURANCE COMPANY | $6 | — | $6 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $451 | $2K | 19.87% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 S. 3RD. ST., SUITE 800 COLUMBUS, OH 432155194 | METROPOLITAN LIFE INSURANCE COMPANY | $41 | $3 | $44 | 0.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $181 | $1K | 22.77% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 S. 3RD ST., SUITE 800 COLUMBUS, OH 43215 | METROPOLITAN LIFE INSURANCE COMPANY | -$1 | — | -$1 | -0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $392 | $1K | 26.86% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 S. 3RD ST. SUITE 800 COLUMBUS, OH 432155194 | METROPOLITAN LIFE INSURANCE COMPANY | $22 | $2 | $24 | 0.44% |
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 | 241 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 5 carriers) | HEALTH NET | 189 | $2.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 465 | $243K |
| Vision | VISION SERVICE PLAN | 147 | $24K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 465 | $243K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 465 | $243K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 465 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 465 | — |
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.