| 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 | $192K | $2K | $194K | 5.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | — | $2K | $2K | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UPMC HEALTH OPTIONS | $10K | — | $10K | 2.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | STANDARD INSURANCE COMPANY | $15K | $2K | $17K | 12.34% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 1.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 4.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $209 | — | $209 | 2.13% |
| IMA, INC.3 | P.O. BOX 102833 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $60 | — | $60 | 0.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $25 | — | $25 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UPMC HEALTH OPTIONS | $218 | — | $218 | 3.72% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1420 5TH AVE. SUITE 1500 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $184 | — | $184 | 4.14% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS. SERVICES INC. - HQ | 18100 VON KARMAN AVE. 10TH FLOOR IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $128 | $128 | 2.88% |
| WANGLIN, RONALD, CHASE3 Filed as: WANGLIN, RONALD CHASE | P.O. BOX 6030 PASADENA, CA 911026030 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $90 | $24 | $114 | 2.56% |
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 | 255 | 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) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 451 | $4.0M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 451 | $3.6M |
| Vision | BLUE CROSS OF CALIFORNIA | 451 | $3.6M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 260 | $165K |
| Short-term disability(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 260 | $170K |
| Long-term disability(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 260 | $170K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 451 | $4.0M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 451 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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.