| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $50K | $143 | $50K | 4.40% |
| CHARLES N. CRAVINGS JR3 | 1467 W. 49TH STREET LOS ANGELES, CA 90062 | AFLAC | $5K | $358 | $5K | 11.90% |
| DAVID HERNANDEZ3 | 2239 W. 190TH STREET TORRANCE, CA 90504 | AFLAC | $5K | — | $5K | 11.75% |
| MS BENEFITS3 Filed as: MS BENEFITS LLC | 100 CHALLENGER ROAD SUITE 400 RIDGEFIELD PARK, NJ 07660 | AFLAC | $2K | — | $2K | 4.45% |
| SARAH ELLIN EDWARDS3 | 5211 PACIFIC CONCOURSE DRIVE APT. 1254 LOS ANGELES, CA 90045 | AFLAC | $2K | — | $2K | 4.19% |
| ANA FRANCIS CORDOVA3 | 14427 CERISE AVENUE APT. 20 HAWTHORNE, CA 90250 | AFLAC | $1K | $240 | $2K | 3.51% |
| JUAN MARTINEZ3 Filed as: JUAN MANUEL MARTINEZ | 10215 S. 10TH AVENUE APT. 3 INGLEWOOD, CA 90303 | AFLAC | $1K | $139 | $1K | 3.19% |
| TAMIE ELAINE JOHNSON3 | 18427 STUDEBAKER ROAD APT. 219 CERRITOS, CA 90703 | AFLAC | $1K | — | $1K | 2.96% |
| LAURA K. LYNCH3 | 117 PROSPECT AVENUE HERMOSA BEACH, CA 90254 | AFLAC | $771 | — | $771 | 1.75% |
| PETER GANCHEV BUDEVSKI3 | 2501 W. REDONDO BEACH BLVD. APT. 232 GARDENA, CA 90249 | AFLAC | $592 | $35 | $627 | 1.42% |
| JASMINE SALAZAR3 | 2239 W. 190TH STREET TORRANCE, CA 90504 | AFLAC | $288 | $79 | $367 | 0.83% |
| BRANDON TYLOR-DA SHIRLEY3 | 5110 S. SHERBOURNE DRIVE LOS ANGELES, CA 90056 | AFLAC | $335 | — | $335 | 0.76% |
| TAMI FUKUSHIMA3 | P.O. BOX 3757 BEVERLY HILLS, CA 90212 | AFLAC | $275 | — | $275 | 0.62% |
| MYKISHA L. THOMAS3 Filed as: MYKISHA L. BUTLER | 3886 3RD AVENUE LOS ANGELES, CA 90008 | AFLAC | $205 | $38 | $243 | 0.55% |
| CHRISTIE D'AMORE3 | 5372 E. APPIAN WAY LONG BEACH, CA 90803 | AFLAC | $92 | — | $92 | 0.21% |
| CHARLES O'COPELAND3 | 1241 W. 81ST STREET LOS ANGELES, CA 90044 | AFLAC | $74 | — | $74 | 0.17% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $67 | — | $67 | 0.15% |
| JOSHUA STORM LEBEAU KIMPSON3 | 18325 MILMORE AVENUE CARSON, CA 90746 | AFLAC | $55 | — | $55 | 0.12% |
| STEVEN R. JOHNSON3 | 2239 W. 190TH STREET TORRANCE, CA 90504 | AFLAC | $4 | — | $4 | 0.01% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $2 | — | $2 | 0.00% |
| CHRISTOPHER HAGER3 | 44 COLONIAL DRIVE RANCHO MIRAGE, CA 92270 | 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 | 212 | 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) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 186 | $1.2M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 186 | $1.1M |
| Other | AFLAC | 85 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.