| 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. | $110K | $6K | $116K | 3.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $51K | $3K | $54K | 4.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $19K | — | $19K | 7.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $9K | — | $9K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $9K | — | $9K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $3K | — | $3K | 2.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $8K | $12K | 9.35% |
| WILLNER-MARCH-WHITTEKER3 Filed as: WILLNER-WHITEKER INSURANCE SERVICE | 1550 W. COLORADO BLVD. PASADENA, CA 91105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $78 | — | $78 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | FOUR EVER LIFE INSURANCE CO. | $894 | — | $894 | 8.00% |
| 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 | 2,434 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,448 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,888 | $4.4M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 1,888 | $1.4M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,062 | $149K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 17 | $247K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,442 | $186K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,554 | $175K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,888 | $4.4M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS OF CALIFORNIA | 1,888 | $1.2M |
| Other(2 contracts, 2 carriers) | ACI FINANCE DEPARTMENT | 2,366 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,366 | — |
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.