| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA HEALTH, INC. | $39K | — | $39K | 4.99% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N. 40TH STREET SUITE 234 PHOENIX, AZ 85018 | AETNA HEALTH, INC. | $13K | — | $13K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNION SECURITY INSURANCE COMPANY | $6K | — | $6K | 7.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 5.06% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N. 40TH STREET SUITE 234 PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $336 | — | $336 | 0.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 19.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UDC DENTAL OF CALIFORNIA, INC. | $870 | — | $870 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | GERBER LIFE INSURANCE CO. | $694 | — | $694 | 8.81% |
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 | 107 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 123 | $824K |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 107 | $91K |
| Vision | GERBER LIFE INSURANCE CO. | 53 | $8K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 107 | $82K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 107 | $82K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 107 | $82K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 123 | $824K |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 107 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.