| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | BLUE CROSS OF CALIFORNIA | $97K | $6K | $103K | 3.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $45K | — | $45K | 1.51% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $54K | $102 | $54K | 4.50% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $5K | 5.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 4.03% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 3.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | — | $368 | $368 | 0.36% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | EYEMED VISION CARE | $2K | — | $2K | 6.95% |
| PATRICK KIRCHNER3 | 422 WAUPONSEE ST. C/O GIS BENEFITS OF FLORIDA INC. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $102 | $3K | 20.38% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $575 | $130 | $705 | 5.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $378 | — | $378 | 2.90% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $360 | — | $360 | 2.76% |
| PATRICK KIRCHNER3 | 422 WAUPONSEE ST. C/O GIS BENEFITS OF FLORIDA INC. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $727 | $114 | $841 | 8.52% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $454 | $119 | $573 | 5.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $113 | — | $113 | 1.14% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $99 | — | $99 | 1.00% |
| PATRICK KIRCHNER3 | 422 WAUPONSEE ST. C/O GIS BENEFITS OF FLORIDA INC. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $799 | $65 | $864 | 13.11% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $292 | $69 | $361 | 5.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $136 | — | $136 | 2.06% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $98 | — | $98 | 1.49% |
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 | 297 | 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) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 483 | $4.2M |
| Dental | BLUE CROSS OF CALIFORNIA | 483 | $3.0M |
| Vision | EYEMED VISION CARE | 414 | $26K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 544 | $102K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 544 | $102K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 483 | $4.2M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 544 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 544 | — |
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.