| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $49K | $16 | $49K | 4.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN, INSURANCE ADMIN. | 721 S. PARKER STREET SUITE 300 ORANGE, CA 928684732 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 1.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $40K | $40K | 3.88% |
| IMA, INC.3 | 1550 17TH ST. SUITE 600 DENVER, CO 80202 | CALIFORNIA PHYSICIANS' SERVICE | — | $15K | $15K | 1.44% |
| 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') | $9K | — | $9K | 9.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $889 | — | $889 | 0.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 17.94% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 14.33% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $396 | — | $396 | 1.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 18.74% |
| HUB INTERNATIONAL MIDWEST LIMITED5 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 7.92% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $453 | — | $453 | 2.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $721 | $3K | 17.28% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $391 | — | $391 | 2.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $904 | $2K | 15.21% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $208 | — | $208 | 1.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $945 | $743 | $2K | 15.01% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $180 | — | $180 | 1.60% |
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 | 281 | 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) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 146 | $2.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 226 | $103K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $51K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 146 | $2.1M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.