| 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 | $47K | — | $47K | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $111 | $111 | 0.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $91 | $91 | 0.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $598 | — | $598 | 6.57% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 6320 GREENHAVEN DR. CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $238 | — | $238 | 2.62% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES INC. | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | — | $143 | 1.57% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 0.86% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.08% |
| SUSAN GOLD STOKES3 | 17042 PINEHURST LANE APT. D HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $19 | $19 | 0.84% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 186 | $933K |
| Dental | BLUE CROSS OF CALIFORNIA | 186 | $933K |
| Vision | BLUE CROSS OF CALIFORNIA | 186 | $933K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 186 | $946K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 9 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $12K |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 186 | $944K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.