| 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. | $35K | — | $35K | 5.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $21K | $4K | $25K | 5.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $19K | — | $19K | 10.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.65% |
| DANIEL TYLER ADAMSON3 | 405 S. HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $929 | — | $929 | 1.70% |
| VERONICA RINCON3 | 2700 N. MAIN ST. SUITE 601 SANTA ANA, CA 92705 | CONTINENTAL AMERICAN INSURANCE COMPANY | $240 | — | $240 | 0.44% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 1501 ORANGETHORPE SUITE 108 FULLERTON, CA 90620 | CONTINENTAL AMERICAN INSURANCE COMPANY | $144 | — | $144 | 0.26% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S. FIGUEROA ST. 35TH FLOOR LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $128 | — | $128 | 0.23% |
| DANIEL TYLER ADAMSON3 | 2700 N. MAIN ST. SUITE 945 SANTA ANA, CA 92705 | CONTINENTAL AMERICAN INSURANCE COMPANY | $95 | — | $95 | 0.17% |
| JULIE L WOLD3 Filed as: JULIE L. WOLD | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $63 | — | $63 | 0.12% |
| JANICE M ADAMSON3 Filed as: JANICE M. ADAMSON | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 0.10% |
| GINA L GAXIOLA3 Filed as: GINA L. GAXIOLA | 730 MANDEVILLA WAY CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25 | — | $25 | 0.05% |
| ARTHUR LEYVAS3 | 495 E. RINCON ST. SUITE 212 CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| FELIX CORTES3 | 810 25TH ST. SUITE 2409 OGDEN, UT 84401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| MJ INSURANCE3 Filed as: CLAUDIA E. DONOFRIO | 11140 LOS ALAMITOS BLVD. SUITE 201 LOS ALAMITOS, CA 90720 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| CASSANDRA GREEN3 | 10541 CALLE LEE SUITE 125 LOS ALAMITOS, CA 90720 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JASON DAVIS INSURANCE SERVICES INC3 Filed as: JASON DAVIS INSURANCE SERVICES INC. | 10571 CALLE LEE SUITE 171 LOS ALAMITOS, CA 90720 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| 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 | $12K | $6K | $18K | 39.26% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W. 47TH ST. SUITE 900 KANSAS CITY, MO 64112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | -$71 | $3K | $3K | 5.55% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N. 40TH STREET SUITE 234 PHOENIX, AZ 85018 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $2K | $2K | 4.44% |
| BENEFITS AMERICA INSURANCE SERVICES3 | LLC 1800 QUAIL ST., SUITE 110 NEWPORT BEACH, CA 92660 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | -$17 | — | -$17 | -0.04% |
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 | 309 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA HEALTH, INC. | 455 | $1.3M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 455 | $226K |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 455 | $226K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 309 | $47K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 297 | $55K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 309 | $47K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 309 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 455 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.