| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $41K | — | $41K | 5.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | — | $542 | $542 | 0.07% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | $6 | $15K | 4.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | STANDARD INSURANCE COMPANY | $3K | $345 | $3K | 12.24% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | STANDARD INSURANCE COMPANY | — | $255 | $255 | 0.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $222 | $2K | 10.72% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD. SUITE 300 KIRKWOOD, MO 631224042 | METROPOLITAN LIFE INSURANCE COMPANY | — | $10 | $10 | 0.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | ANTHEM LIFE INSURANCE COMPANY | $305 | — | $305 | 2.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $411 | $81 | $492 | 12.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $61 | $21 | $82 | 13.51% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 104 | $1.0M |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF CALIFORNIA | 88 | $53K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 129 | $15K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 197 | $38K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 197 | $38K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 104 | $1.0M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 197 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.