| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $56K | — | $56K | 4.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $48K | $48K | 5.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $11K | — | $11K | 5.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 13.60% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $958 | $958 | 3.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 3.98% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INS. | 550 S. HOPE ST. SUITE 1000 LOS ANGELES, CA 90071 | VISION SERVICE PLAN | $238 | — | $238 | 0.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $538 | $2K | 13.58% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $461 | $461 | 3.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $497 | $2K | 13.59% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $426 | $426 | 3.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 14.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $235 | — | $235 | 5.49% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 204 | $2.0M |
| Dental | AETNA LIFE INSURANCE CO. | 340 | $196K |
| Vision | VISION SERVICE PLAN | 144 | $27K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $14K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $15K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 55 | $833K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.