| 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 | $69K | $1K | $70K | 5.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $7K | $701 | $8K | 7.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $997 | $7K | 16.95% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $736 | $736 | 1.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | EYEMED VISION CARE | $2K | — | $2K | 9.93% |
| JOHNSON RESOURCES3 | 7373 E. DOUBLETREE RANCH SUITE 200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE | — | $403 | $403 | 1.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $417 | $3K | 17.30% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $308 | $308 | 1.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $147 | $1K | 15.48% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $160 | $160 | 2.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $474 | — | $474 | 10.67% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $82 | $13 | $95 | 17.40% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $9 | $9 | 1.65% |
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 | 218 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 180 | $1.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 186 | $96K |
| Vision | EYEMED VISION CARE | 350 | $20K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 209 | $43K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 209 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 209 | $18K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 180 | $1.4M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 209 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.