| 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 | CALIFORNIA PHYSICIANS' SERVICE | — | $107K | $107K | 3.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $31K | — | $31K | 10.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $2K | — | $2K | 3.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $112 | $6K | 15.28% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $601 | $601 | 1.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $103 | $5K | 15.29% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $554 | $554 | 1.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | EMPATHIA PACIFIC, INC. | — | $922 | $922 | 10.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $790 | $14 | $804 | 15.26% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $77 | $77 | 1.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LLOYDS OF LONDON | $1K | — | $1K | 27.80% |
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 | 290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 498 | $3.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 518 | $301K |
| Vision | VISION SERVICE PLAN | 248 | $59K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 285 | $36K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 11 | $10K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 285 | $44K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 498 | $3.5M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 285 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 518 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.