| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $29K | $945 | $30K | 4.39% |
| TINA YOONJUNG KIM3 | 4109 POMPIA WAY CORONA, CA 92883 | KAISER FOUNDATION HEALTH PLAN INC. | $28 | — | $28 | 0.00% |
| LAURA K. LYNCH3 | 117 PROSPECT AVENUE HERMOSA BEACH, CA 90254 | AFLAC | $436 | — | $436 | 4.59% |
| DAVID HERNANDEZ3 | 2239 W. 190TH STREET TORRANCE, CA 90504 | AFLAC | $363 | — | $363 | 3.82% |
| TALHA ZAQUIR RAHMAN3 | 8811 ELDORADO PARKWAY APT. 4101 FRISCO, TX 75033 | AFLAC | $129 | — | $129 | 1.36% |
| STEVEN R. JOHNSON3 | 2239 W. 190TH STREET TORRANCE, CA 90504 | AFLAC | $13 | — | $13 | 0.14% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $6 | — | $6 | 0.06% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVENUE LOS ANGELES, CA 90045 | AFLAC | $1 | — | $1 | 0.01% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 97 | $688K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 97 | $688K |
| Other | AFLAC | 16 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.