| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $107K | $8K | $115K | 3.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | BLUE CROSS OF CALIFORNIA | $57K | — | $57K | 1.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRINCIPAL LIFE INSURANCE COMPANY | $51K | — | $51K | 5.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $3K | — | $3K | 2.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $6K | 4.32% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER, LLC | 1105 N. MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $268 | — | $268 | 0.20% |
| WILLNER-MARCH-WHITTEKER3 Filed as: WILLNER-WHITEKER INSURANCE SERVICE | 1550 W. COLORADO BLVD. PASADENA, CA 91105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $80 | — | $80 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HOLMAN FAMILY COUNSELING, INC. | $3K | — | $3K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | FOUR EVER LIFE INSURANCE CO. | $3K | — | $3K | 8.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | ATLANTIC SPECIALTY INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | FOUR EVER LIFE INSURANCE CO. | $156 | — | $156 | 15.04% |
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 | 2,014 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,028 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,233 | $5.9M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 1,233 | $3.1M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,255 | $193K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 2,014 | $879K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 2,014 | $879K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 2,014 | $879K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,233 | $5.9M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS OF CALIFORNIA | 1,233 | $2.9M |
| Other(3 contracts, 3 carriers) | HOLMAN FAMILY COUNSELING, INC. | 2,956 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,956 | — |
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."
No prospect flags tripped on this filing.