| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIAN'S SERVICE | $34K | — | $34K | 3.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIAN'S SERVICE | $4K | — | $4K | 0.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $1 | $8K | 2.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 12.92% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SERVICES | 32110 AGOURA RD. WESTLAKE VILLAGE, CA 913614026 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $216 | $2K | 5.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 3.00% |
| ENROLLEASE3 Filed as: ENROLLEASE INC. | 500 TREAT AVE. SUITE 200 SAN FRANCISCO, CA 941102068 | METROPOLITAN LIFE INSURANCE COMPANY | — | $877 | $877 | 1.98% |
| PATRICK ALVIN HOLLOWAY3 | 3006 S. VERMONT AVE. SUITE 324 LOS ANGELES, CA 90007 | AFLAC | $2K | $35 | $2K | 5.16% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS CT. BURBANK, CA 91501 | AFLAC | $2K | $19 | $2K | 4.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $1K | — | $1K | 3.27% |
| RHOEL T VALDEZ3 Filed as: RHOEL T. VALDEZ | 20016 BLYTHE ST. WINNETKA, CA 91306 | AFLAC | $396 | $10 | $406 | 1.14% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK | 1620 S. DITMAR ST. OCEANSIDE, CA 92054 | AFLAC | $265 | — | $265 | 0.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $177 | — | $177 | 0.50% |
| DOLORES M. ROMERO3 | 2529 BRENTMOOR CT. SUWANEE, GA 30024 | AFLAC | $171 | — | $171 | 0.48% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN ST. SUITE 700 IRVINE, CA 92614 | AFLAC | $152 | — | $152 | 0.43% |
| DAVID J REESOR3 Filed as: DAVID J. REESOR | 1615 WILSON AVE. UPLAND, CA 91784 | AFLAC | $90 | — | $90 | 0.25% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC. | 43 MILL TOWN LOOP SUITE C BOZEMAN, MT 59718 | AFLAC | $87 | — | $87 | 0.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 43 MILL TOWN LOOP SUITE C BOZEMAN, MT 59718 | AFLAC | $14 | — | $14 | 0.04% |
| KAITLYN AKINS3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | LANDMARK HEALTHPLAN | $2K | — | $2K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | EYEMED VISION CARE | $1K | — | $1K | 9.86% |
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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 150 | $1.2M |
| Vision | EYEMED VISION CARE | 212 | $13K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 247 | $44K |
| Short-term disability | AFLAC | 32 | $36K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 247 | $44K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 150 | $1.2M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 247 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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."
No prospect flags tripped on this filing.