| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $106K | $11K | $116K | 1.94% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KEENAN & ASSOCIATES | PO BOX 4328 TORRANCE, CA 90510 | BLUE CROSS OF CALIFORNIA | $58K | — | $58K | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $13K | $4K | $17K | 0.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $6K | $654 | $7K | 1.94% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KEENAN & ASSOCIATES | PO BOX 4328 TORRANCE, CA 90510 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $798 | $255 | $1K | 0.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | HARTFORD LIFE AND ACCIDENT | $14K | — | $14K | 5.37% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KEENAN & ASSOCIATES | 2355 CRENSHAW BLVD STE 200 TORRANCE, CA 90501 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 2.62% |
| IMA, INC.3 Filed as: IMA INC | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 1.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | — | $386 | $386 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | $3K | — | $3K | 5.43% |
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 | 884 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 891 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 769 | $6.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,103 | $367K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | 1,134 | $56K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,116 | $270K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,116 | $270K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,116 | $270K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 769 | $6.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 1,116 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,134 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.