| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | BLUE CROSS OF CALIFORNIA | $91K | $6K | $97K | 5.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | -$76 | — | -$76 | -0.00% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $68K | $161 | $69K | 5.00% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 4.77% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | ANTHEM LIFE INSURANCE COMPANY | $8K | — | $8K | 9.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 1.48% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS (SEE ATTACHED) | — | AFLAC | $10K | $146 | $10K | 17.85% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 430 E. DOUGLAS AVE. SUITE 400 WICHITA, KS 672023409 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 4.93% |
| CENTRO BENEFITS RESEARCH LLC3 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE COMPANY | — | $753 | $753 | 3.36% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | KAISER FOUNDATION HEALTH PLAN, INC. | $590 | — | $590 | 3.94% |
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 | 479 | 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) | 479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 518 | $3.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 518 | $1.9M |
| Vision | BLUE CROSS OF CALIFORNIA | 518 | $1.9M |
| Life insurance(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 568 | $162K |
| Short-term disability | AFLAC | 47 | $58K |
| Prescription drug(4 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 518 | $3.5M |
| Other(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 568 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 568 | — |
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.