| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $108K | $417 | $109K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | ARMADACARE | $3K | — | $3K | 1.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LLOYDS OF LONDON | $2K | — | $2K | 12.11% |
| MICHELLE C. LEE3 | 1044 LOMA LISA LANE ARCADIA, CA 91006 | AFLAC | $371 | — | $371 | 4.44% |
| KATHY DUFFY INSURANCE SERVICES3 | 10442 ORMOND STREET SHADOW HILLS, CA 91040 | AFLAC | $350 | — | $350 | 4.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $147 | — | $147 | 1.76% |
| MICHAEL R. FISHER3 | 50 W. LEMON AVENUE SUITE 2 MONROVIA, CA 91016 | AFLAC | $143 | — | $143 | 1.71% |
| KATHY DUFFY INSURANCE SERVICES3 | KATHLEEN DUFFY-LARSON 10442 ORMOND STREET SHADOW HILLS, CA 91040 | AFLAC | $677 | $19 | $696 | 9.14% |
| MICHELLE C. LEE3 | 1044 LOMA LISA LANE ARCADIA, CA 91006 | AFLAC | $237 | $5 | $242 | 3.18% |
| JENNIFER KARSTING3 | 17671 COWAN SUITE 125 IRVINE, CA 92614 | AFLAC | $84 | — | $84 | 1.10% |
| MICHAEL R. FISHER3 | 50 W. LEMON AVENUE SUITE 2 MONROVIA, CA 91016 | AFLAC | $77 | $5 | $82 | 1.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $65 | — | $65 | 0.85% |
| ALYSSA JOAN GUBA3 | 15222 TAYLOR WAY TUSTIN, CA 92782 | AFLAC | $56 | — | $56 | 0.74% |
| ANDRES ORLANDO TRUJILLO3 | 205 S. BROADWAY SUITE 208 LOS ANGELES, CA 90012 | AFLAC | $49 | — | $49 | 0.64% |
| EXECUTIVE CONSULTANTS GROUP INC.3 | 1936 E. DEERE AVENUE SUITE 215 SANTA ANA, CA 92705 | AFLAC | $32 | — | $32 | 0.42% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 11739 HICKORY RUN COURT LOVELAND, OH 45140 | AFLAC | $12 | — | $12 | 0.16% |
| MICHAEL G. TURNER3 | 4657 GUAVA AVENUE SEAL BEACH, CA 90740 | AFLAC | $12 | — | $12 | 0.16% |
| JAMES J GRETHEL3 Filed as: JAMES J. GRETHEL | 865 CEDAR DRIVE LOVELAND, OH 45140 | AFLAC | $3 | — | $3 | 0.04% |
| KERSTIN J VANZANTEN3 Filed as: KERSTIN J. VANZANTEN | 40152 STOWE ROAD TEMECULA, CA 92591 | AFLAC | $3 | — | $3 | 0.04% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON INC. | 2211 MICHELSON DRIVE SUITE 1150 IRVINE, CA 92612 | AFLAC | $2 | — | $2 | 0.03% |
| DALE IRA DAVIS3 | 5982 CEDARCREEK LANE LEXINGTON, KY 40515 | AFLAC | $1 | — | $1 | 0.01% |
| OWEN JOHNSTON3 | 1231 W. 2ND STREET SANTA ANA, CA 92703 | AFLAC | $1 | — | $1 | 0.01% |
| PATRICIA SWANSON4 | 579 W. LEMON AVENUE MONROVIA, CA 91016 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $454 | — | $454 | 15.27% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $83 | — | $83 | 2.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $30 | $30 | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $199 | $199 | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $312 | $3K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $28 | $28 | — |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $2.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $2.3M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $2.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 200 | $0 |
| Short-term disability(2 contracts, 2 carriers) | LLOYDS OF LONDON | 200 | $15K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 200 | $0 |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $2.3M |
| Other(4 contracts, 3 carriers) | AFLAC | 200 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.