| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $40K | $40K | 3.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $27K | $27K | 2.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 911076024 | HUMANA INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $242 | $242 | 1.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | HUMANADENTAL INSURANCE COMPANY | $1K | — | $1K | 9.96% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $196 | $196 | 1.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $136 | $136 | 1.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $612 | — | $612 | 10.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $35 | $35 | 0.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $556 | — | $556 | 15.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $70 | — | $70 | 10.00% |
| NATIONAL BNEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4 | $4 | 0.57% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 164 | $1.2M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 104 | $71K |
| Vision | HUMANA INSURANCE COMPANY | 104 | $60K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $20K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 56 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 65 | $26K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 164 | $1.2M |
| Other(5 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.