| 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 | CALIFORNIA PHYSICIANS' SERVICE | $17K | $93K | $110K | 5.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 20.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 20.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $761 | $3K | 20.71% |
| MASTERCARE SOLUTIONS, INC.3 Filed as: MASTERCARE SOLUTIONS INC. | 19085 PINEHURST RD. BEND, OR 97703 | TRANSAMERICA LIFE INSURANCE COMPANY | $748 | — | $748 | 5.70% |
| WILLIAM WETMORE3 | 392 HERITAGE DR. GETTYSBURG, PA 17325 | TRANSAMERICA LIFE INSURANCE COMPANY | $218 | — | $218 | 1.66% |
| LINDA ANN KALYK-HOROWITZ3 | 6199 BROKEN TOP DR. BEND, OR 97702 | TRANSAMERICA LIFE INSURANCE COMPANY | $184 | — | $184 | 1.40% |
| CATHERINE LEWIS3 | 900 S. MEADOWS PKWY APT 3923 RENO, NV 89521 | TRANSAMERICA LIFE INSURANCE COMPANY | $149 | — | $149 | 1.14% |
| NATHAN SANOW3 | 13208 NW 33RD AVENUE VANCOUVER, WA 98685 | TRANSAMERICA LIFE INSURANCE COMPANY | $118 | — | $118 | 0.90% |
| MASTERCARE LLC3 | 1220 MAIN ST. SUITE 400 VANCOUVER, WA 98660 | TRANSAMERICA LIFE INSURANCE COMPANY | $93 | — | $93 | 0.71% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS. SERVICES INC. | 685 CARNEGIE DR. SUITE 265 SAN BERNARDINO, CA 92408 | TRANSAMERICA LIFE INSURANCE COMPANY | $64 | — | $64 | 0.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $622 | $2K | 20.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $965 | $562 | $2K | 15.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $746 | — | $746 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $302 | $1K | 19.35% |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 231 | $1.9M |
| Dental | CALIFORNIA PHYSICIANS' SERVICE | 231 | $1.9M |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 231 | $1.9M |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $49K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 33 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $30K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 231 | $1.9M |
| Other(6 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.