| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $101K | — | $101K | 4.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $35K | — | $35K | 10.93% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 SOUTH THIRD STREET SUITE 800 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $90 | — | $90 | 0.03% |
| SHARON S. WIENER3 | 8833 PICKFORD ST. LOS ANGELES, CA 90035 | AFLAC | $2K | $403 | $3K | 7.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $1K | — | $1K | 3.38% |
| CARLOS E. GARCIA3 | 1034 N. KINGSLEY DR. APT 11 LOS ANGELES, CA 90029 | AFLAC | $925 | — | $925 | 2.41% |
| DESIREE DEWYSE3 | 451 N. SUMMIT AVE. PASADENA, CA 91103 | AFLAC | $855 | — | $855 | 2.23% |
| DENNY P. TWIGG3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $641 | — | $641 | 1.67% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 265 W. NAOMI AVE. ARCADIA, CA 91007 | AFLAC | $380 | — | $380 | 0.99% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BLVD. SUITE 1225 LOS ANGELES, CA 90025 | AFLAC | $240 | $69 | $309 | 0.80% |
| GINA L GAXIOLA3 Filed as: GINA L. GAXIOLA | 730 MANDEVILLA WAY CORONA, CA 92879 | AFLAC | $203 | $59 | $262 | 0.68% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 265 W. NAOMI AVE. ARCADIA, CA 91007 | AFLAC | $242 | — | $242 | 0.63% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $232 | — | $232 | 0.60% |
| MICHAEL PAUL LAMASA3 | 5034 CAHUENGA BLVD. APT 2 NORTH HOLLYWOOD, CA 91601 | AFLAC | $202 | — | $202 | 0.53% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 1502 BROADWAY UNIT 308 SANTA MONICA, CA 90404 | AFLAC | $117 | $69 | $186 | 0.48% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 11620 WILSHIRE BLVD. SUITE 210 LOS ANGELES, CA 90025 | AFLAC | $123 | — | $123 | 0.32% |
| JULIE L WOLD3 Filed as: JULIE L. WOLD | 10370 HEMET STREET 210 RIVERSIDE, CA 92503 | AFLAC | $71 | $12 | $83 | 0.22% |
| JULISSA JEANETTE BARTON3 | P.O. BOX 882124 LOS ANGELES, CA 90009 | AFLAC | $76 | — | $76 | 0.20% |
| CHRISTOPHER RYAN CORDON3 | 1080 BLACKHAWK DR. ELGIN, IL 60120 | AFLAC | $64 | — | $64 | 0.17% |
| JANICE M ADAMSON3 Filed as: JANICE M. ADAMSON | 495 E. RINCON ST. SUITE 212 CORONA, CA 92879 | AFLAC | $40 | $14 | $54 | 0.14% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $50 | — | $50 | 0.13% |
| GABRIEL R JAUREGUI3 Filed as: GABRIEL R. JAUREGUI | 7155 CEDAR CREEK RD CORONA, CA 92880 | AFLAC | $31 | $13 | $44 | 0.11% |
| ALEJANDRO RAMIREZ3 | 10619 SHELLYFIED RD. DOWNEY, CA 90241 | AFLAC | $31 | $8 | $39 | 0.10% |
| BETTY MURDOCK3 | 2980 FLORINE AVE. RIVERSIDE, CA 92509 | AFLAC | $36 | — | $36 | 0.09% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $34 | — | $34 | 0.09% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 600 S. HIDDEN VALLEY RD. APT 150 CARLSBAD, CA 92011 | AFLAC | $20 | $14 | $34 | 0.09% |
| MIKE LUNDQUIST3 | 4541 S. MOSSY SPRINGS LN SALT LAKE CITY, UT 84117 | AFLAC | $19 | — | $19 | 0.05% |
| JOSEPH HOFFMAN3 | 1623 CAMINO DE SALMON ST. CORONA, CA 92881 | AFLAC | $13 | $3 | $16 | 0.04% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES LTD | 303 W. ERIE ST. SUITE 400 CHICAGO, IL 60654 | AFLAC | $11 | — | $11 | 0.03% |
| PATRICK M PECORARO3 Filed as: PATRICK M. PECORARO | 8180 SOUTH 700 EAST SUITE 120 SANDY, UT 84070 | AFLAC | $7 | — | $7 | 0.02% |
| CLARY W. CAMPBELL3 | 14720 LIBLEN AVE. BELLFLOWER, CA 90706 | AFLAC | $7 | — | $7 | 0.02% |
| MARC MICKELSEN3 Filed as: MARC MICHELSEN | 1324 S. 1900 E SALT LAKE CITY, UT 84108 | AFLAC | $6 | — | $6 | 0.02% |
| JANICE M ADAMSON3 Filed as: JANICE M. ADAMSON | 10370 HEMET ST. SUITE 210 RIVERSIDE, CA 92503 | AFLAC | $5 | — | $5 | 0.01% |
| DAMON R STREETMAN3 Filed as: DAMON R. STREETMAN | 2961 W. MAPLE LOOP DR. SUITE 230 LEHI, UT 84043 | AFLAC | $3 | — | $3 | 0.01% |
| KAREN M HUGHES3 Filed as: KAREN H. HUGHES | 3120 NE 47TH ST. FORT LAUDERDALE, FL 33308 | AFLAC | $3 | — | $3 | 0.01% |
| MARK D BARBIER3 Filed as: MARK D. BARBIER | 802 DEER TRAIL LN OAK BROOK, IL 60523 | AFLAC | $1 | — | $1 | 0.00% |
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 | 358 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 337 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 375 | $317K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 375 | $317K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 375 | $355K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 375 | $355K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 375 | $317K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 375 | $355K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.