| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | KAISER | $51K | $4K | $55K | 1.88% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | — | KAISER | $36K | — | $36K | 1.23% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC | — | CIGNA | $26K | — | $26K | 3.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | CIGNA | $25K | — | $25K | 3.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | CIGNA | $16K | — | $16K | 5.02% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC. | — | CIGNA | $15K | — | $15K | 4.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $699 | $14K | 12.40% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 5.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $260 | $5K | 12.22% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | VISION SERVICE PLAN | $2K | — | $2K | 5.89% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC | — | VISION SERVICE PLAN | $2K | — | $2K | 4.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $88 | $2K | 12.32% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $767 | — | $767 | 5.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $54 | $1K | 11.71% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $674 | — | $674 | 6.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $618 | — | $618 | 6.75% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $152 | — | $152 | 1.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $696 | — | $696 | 7.64% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $150 | — | $150 | 1.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $466 | — | $466 | 7.14% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $98 | — | $98 | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 5201 GREAT AMERICA PARKWAY SUITE 332 SANTA CLARA, CA 95054 | TELADOC HEALTH, INC. | $940 | — | $940 | 14.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | — | METLIFE LEGAL PLANS | $414 | $39 | $453 | 8.70% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC | — | METLIFE LEGAL PLANS | $105 | $36 | $141 | 2.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 TPA | Contract Administrator; Claims processing Service code 12 | — | $112K |
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 | 419 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 75 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER | 477 | $3.6M |
| Dental | CIGNA | 301 | $314K |
| Vision | VISION SERVICE PLAN | 232 | $41K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 416 | $110K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $11K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 71 | $41K |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 416 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 477 | — |
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.