| 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 | BLUE CROSS OF CALIFORNIA | $241K | $20K | $261K | 4.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | — | $28K | 4.77% |
| 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 | $11K | $866 | $11K | 4.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | ANTHEM LIFE INSURANCE COMPANY | $7K | $599 | $8K | 4.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 4.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $4K | — | $4K | 4.82% |
| VARIOUS - SEE ATTACHED3 | C/O COLONIAL - PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT | $3K | $271 | $3K | 21.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES, LLC | 3475 E FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | ZURICH AMERICAN INSURANCE COMPANY | $291 | — | $291 | 15.02% |
| IMA, INC.3 Filed as: IMA CORP | 1705 17TH ST., STE. 100 DENVER, CO 80202 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $45 | — | $45 | 7.83% |
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 | 464 | 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) | 471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 391 | $6.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 391 | $5.6M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 462 | $245K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 462 | $245K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 459 | $169K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 459 | $169K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 391 | $6.3M |
| Other(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 462 | $261K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 462 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.