| 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. | $25K | — | $25K | 5.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 4.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $2K | $426 | $3K | 8.85% |
| MICHELLE C. LEE3 Filed as: MICHELLE LEE | 1044 LOMA LISA LN. ARCADIA, CA 91006 | AFLAC | $821 | $49 | $870 | 4.34% |
| RICKY SHIH3 | 314 S. 3RD AVE. ARCADIA, CA 91006 | AFLAC | $655 | $42 | $697 | 3.48% |
| MICHAEL R. FISHER3 | 50 W. LEMON AVE. SUITE 2 MONROVIA, CA 91016 | AFLAC | $216 | $28 | $244 | 1.22% |
| RATTNAK SOKHOM3 | 403 N. NEW AVE. MONTEREY PARK, CA 91755 | AFLAC | $98 | $31 | $129 | 0.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $125 | — | $125 | 0.62% |
| KEVIN MICHAEL NAGLE3 | 32 ESPERANZA AVE. APT. F SIERRA MADRE, CA 91024 | AFLAC | $106 | $19 | $125 | 0.62% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 701 ALBEROSKY WAY BATAVIA, IL 60510 | AFLAC | $35 | — | $35 | 0.17% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 201 S. MAPLE AVE. APT 104 OAK PARK, IL 60302 | AFLAC | $31 | — | $31 | 0.15% |
| GUY M. WELCH3 | 5414 MERCEDES AVE. DALLAS, TX 75206 | AFLAC | $27 | — | $27 | 0.13% |
| LEANN C LEVINE3 Filed as: LEANN C. LEVINE | 1049 16TH ST. APT. 9 SANTA MONIA, CA 90403 | AFLAC | $25 | — | $25 | 0.12% |
| STEVE CRAIG GOLDSTEIN3 | 6255 VENTURA CANYON AVE. VAN NUYS, CA 91401 | AFLAC | $13 | — | $13 | 0.06% |
| MAYNARD M. YOUNG3 Filed as: MAYNARD M.YOUNG | 20 HOBBS RD. EFFINGHAM, NH 03882 | AFLAC | $10 | — | $10 | 0.05% |
| VINCENT C HING3 Filed as: VINCENT C. HING | 4536 RINETTI LN. LA CANADA, CA 91011 | AFLAC | $9 | — | $9 | 0.04% |
| DAVID M COUGHLIN3 Filed as: DAVID M. COUGHLIN | 2229 WHITE MIST DR. LAS VEGAS, NV 89134 | AFLAC | $4 | — | $4 | 0.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER ST. ORANGE, CA 92868 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $6K | $6K | 74.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $750 | $284 | $1K | 13.61% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 179 | $669K |
| Vision | AETNA LIFE INSURANCE CO. | 179 | $30K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 150 | $8K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 179 | $497K |
| Other(2 contracts, 2 carriers) | AFLAC | 150 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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.