| 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. | $26K | $3K | $29K | 5.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HEALTH NET | $25K | — | $25K | 4.86% |
| JENNIFER AURORA RAMIREZ3 | 1053 FICUS LANE SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16K | $1K | $17K | 12.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY INSURANCE BROKERS | P.O. BOX 6030 PASADENA, CA 91102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 8.33% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 3.95% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $810 | $4K | 3.16% |
| LILIANA RIVERA3 | 25671 TONADILLA CIR. MORENO VALLEY, CA 92551 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $518 | $4K | 3.05% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON ST. RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 2.61% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $440 | $2K | 1.65% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $13 | $1K | 0.79% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | $529 | $762 | 0.59% |
| BRETT WELTY INSURANCE AGENCY INC3 Filed as: BRETT WELTY INSURANCE AGENCY INC. | 10769 WOODSIDE AVE. SANTEE, CA 92071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $697 | — | $697 | 0.54% |
| BRIAN ROBERT LLOYD3 | 3053 COPPERWOOD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | $422 | $655 | 0.51% |
| LORI LAINE3 | 35837 CARTER ST. YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $240 | — | $240 | 0.19% |
| BRIAN YERVANT AKIAN3 | P.O. BOX 17269 IRVINE, CA 92623 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $192 | $23 | $215 | 0.17% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC. | 3470 MT. DIABLO BLVD. LAFAYETTE, CA 94549 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | — | $208 | 0.16% |
| JB CREATIVE SOLUTIONS LLC3 | 1933 JOE POOL DR. LITTLE ELM, TX 75068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $160 | $29 | $189 | 0.15% |
| RAYMOND KWOCKMAN GONG3 | 2180 FENTON PKWY SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| BRUCE W BUSSER3 Filed as: BRUCE W. BUSSER | 22461 SAN JOAQUIN DRIVE WEST CANYON LAKE, CA 92587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| ROGER STUART KENCHEL3 | 2588 EL CAMINO REAL CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARIA LOURDES MENDOZA3 | 26443 SAN PALM CT. MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 WEST OREN, UT 84059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | — | $13K | 11.42% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 83 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 290 | $111K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 290 | $111K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 290 | $240K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 71 | $129K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 290 | $111K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 290 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.