| 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 | $111K | $1K | $113K | 4.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | — | $1K | $1K | 0.04% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $62K | $21 | $62K | 4.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $1K | $16K | 16.09% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 6.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | EYEMED VISION CARE | $1K | — | $1K | 6.83% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | EYEMED VISION CARE | $279 | — | $279 | 1.35% |
| PATRICK KIRCHNER3 | 422 WAUPONSEE ST. C/O GIS BENEFITS OF FLORIDA INC. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $471 | $236 | $707 | 7.03% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $552 | $138 | $690 | 6.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $202 | $51 | $253 | 2.52% |
| PATRICK KIRCHNER3 | 422 WAUPONSEE ST. C/O GIS BENEFITS OF FLORIDA INC. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $543 | $130 | $673 | 10.28% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $352 | $86 | $438 | 6.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $233 | $28 | $261 | 3.99% |
| PATRICK KIRCHNER3 | 422 WAUPONSEE ST. C/O GIS BENEFITS OF FLORIDA INC. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $712 | $98 | $810 | 15.10% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $303 | $71 | $374 | 6.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $305 | $21 | $326 | 6.08% |
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 | 279 | 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) | 279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 457 | $3.6M |
| Dental | BLUE CROSS OF CALIFORNIA | 457 | $2.3M |
| Vision(2 contracts) | EYEMED VISION CARE | 400 | $21K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 540 | $100K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 540 | $100K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 457 | $3.6M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 540 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 540 | — |
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.