| 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. | $78K | — | $78K | 4.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $73K | — | $73K | 5.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMAPNY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $3K | $8K | 4.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY INSURANCE BROKERS | P.O. BOX 6030 PASADENA, CA 91102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18K | $1K | $19K | 11.31% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 3.90% |
| JONATHAN MARK DAHL3 | 1722 DIXON ST. REDONDO BEACH, CA 90278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 2.59% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $4K | 2.55% |
| NICHOLAS RYAN DERRICO3 | 1745 W. ORANGEWOOD AVE. SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $3K | $4K | 2.31% |
| ANTOINETTE MARI GARCIA3 | 1745 ORANGEWOOD AVE. UNIT 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $3K | $4K | 2.30% |
| LUZ CASTILLO BARRIGA3 | 22019 JUAN AVE. HAWAIIAN GARDENS, CA 90716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $253 | $3K | 1.94% |
| RONALD JAMES GULLION3 | 7750 BAIRNSDALE ST. DOWNEY, CA 90240 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 1.55% |
| ELIZABETH JEAN HEBER3 | 2511 W. SUNFLOWER AVE. SANTA ANA, CA 92704 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $248 | $1K | 0.83% |
| JAMES P BOADA3 Filed as: JAMES PATRICK BOADA | 30991 VIA MIRADOR SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $602 | $484 | $1K | 0.63% |
| LILIANA RIVERA3 | 25671 TONADILLA CIR. MORENO VALLEY, CA 92551 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $975 | $100 | $1K | 0.63% |
| LAURA LETICIA RENOVA3 | 2048 AUDREY HEPBURN ST. LAS VEGAS, NV 89142 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $802 | $149 | $951 | 0.55% |
| EDITH VIEYRA3 | 1432 EAST MARKET ST. LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $860 | $32 | $892 | 0.52% |
| ROSA MURILLO PUENTE3 | 6143 UTE DR. SAN JOSE, CA 95123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $695 | $191 | $886 | 0.52% |
| BRIAN ROSS MENDENHALL3 | 641 W. PALM DR. PLACENTIA, CA 92870 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $803 | — | $803 | 0.47% |
| JCASTELLANOS AND ASSOCIATES INC3 Filed as: JCASTELLANOS AND ASSOCIATES INC. | 7441 FIGURA DR. JUSTICE, IL 60458 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $666 | $14 | $680 | 0.40% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $450 | $125 | $575 | 0.34% |
| JESSICA RENEE GREENE3 | 630 S. INDIAN HILL BLVD. CLAREMONT, CA 91711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $542 | $30 | $572 | 0.33% |
| CELIFLORA THOMPSON3 | 3763 MORNING DOVE AVE. MERCED, CA 95348 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $484 | $17 | $501 | 0.29% |
| GINNY ELIZABETH CRISTALES3 | 43 COUNTRY MILE RD. POMONA, CA 91766 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $430 | — | $430 | 0.25% |
| BRENT D BUFFONE3 Filed as: BRENT D. BUFFONE | 508 N. 22ND ST. LAS VEGAS, NV 89101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $417 | — | $417 | 0.24% |
| SAMUEL DAVID WESLEY3 | 9711 LAUREL ST. BELLFLOWER, CA 90706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $319 | — | $319 | 0.19% |
| CANDACE ELISE EUSEBIO3 | 124 AMBERSTONE LANE SAN RAMON, CA 94582 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $282 | $4 | $286 | 0.17% |
| RON BLAIR3 | 1857 TULANE AVENUE LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $174 | $259 | 0.15% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $118 | $216 | 0.13% |
| ERNESTO ELOY GARCIA3 | 4710 FALLON PL. DALLAS, TX 75227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $181 | $20 | $201 | 0.12% |
| BENJAMIN ACEVEDO3 | 16211 E. GROVECENTER ST. COVINA, CA 91722 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $192 | — | $192 | 0.11% |
| ERIC BROGAN3 Filed as: ERIC L. MILLER | 4505 W. PIONEER DR. IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $172 | $9 | $181 | 0.11% |
| MAIRA MAGALI ORTIZ3 | 43642 35TH ST. EAST LANCASTER, CA 93535 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $7 | $164 | 0.10% |
| SANDRA E GONZALEZ3 Filed as: SANDRA E. GONZALEZ | 2037 W. BULLARD AVE. FRESNO, CA 93711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $162 | — | $162 | 0.09% |
| HAD LI ENTERPRISES INCORPORATED3 Filed as: HAD LI ENTERPRISES INC. | 11432 SOUTH ST., UNIT 303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | $19 | $161 | 0.09% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | $19 | $150 | 0.09% |
| BENEFITTING YOU INC3 Filed as: BENEFITTING YOU INC. | 2497 CITRUS GARDEN CIRCLE HENDERSON, NV 89052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $24 | $141 | 0.08% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $107 | $140 | 0.08% |
| JORGE ALEJANDRO MONTEMAYOR3 Filed as: JORGE H. CASTELLANOS | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | $17 | $121 | 0.07% |
| WENDY SUE GERSHOW3 | 3217 STAR AVE. OAKLAND, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $111 | $1 | $112 | 0.07% |
| BRIAN ROBERT LLOYD3 | P.O. BOX 11 KNIGHTSEN, CA 94548 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $77 | $110 | 0.06% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | P.O. BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $24 | $63 | 0.04% |
| CATHERINE LISA LUKE3 | 4787 W. HACIENDA AVE. CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $23 | $58 | 0.03% |
| THERESA NETTO PHILLIPS3 | 6219 S. CLARA AVE. FRESNO, CA 93706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $12 | $51 | 0.03% |
| YVETTE KORINA HERNANDEZ3 Filed as: YVETTE KORINA HERRNANDEZ | 1208 WHITTIER AVE. BREA, CA 92821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $38 | $48 | 0.03% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE. SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $1 | $36 | 0.02% |
| FRANCISCO X CABRERA3 Filed as: FRANCISCO X. CABRERA | P.O. BOX 1871 FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $4 | $35 | 0.02% |
| PENELOPE ROSAS3 | 7300 HENNEMAN WAY MCKINNEY, TX 75070 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $3 | $29 | 0.02% |
| ELITTESOLUTIONS LTD3 | 1882 E. 104TH AVE. DENVER, CO 80233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $18 | $28 | 0.02% |
| KAREN TYLER-DUNN3 | 714 SEYMOUR DR. FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $6 | $24 | 0.01% |
| CATHY BUFFONE3 | 8255 SOUTH LAS VEGAS BLVD. LAS VEGAS, NV 89123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $3 | $23 | 0.01% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.01% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FT. WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| KEYSHA LATRICE GWIN3 | 1357 SOUTH STALEY DRIVE LOS ANGELES, CA 90019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.00% |
| ERICA DEZESE JENKINS3 | 2015 1/2 47TH AVE. OAKLAND, CA 94601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 0.00% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.00% |
| DANIEL CORY3 | 300 E. 17TH AVE. DENVER, CO 80203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.00% |
| MPART BENEFITS INC3 Filed as: MPART BENEFITS INC. | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 10.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | AXIS INSURANCE COMPANY | $2K | — | $2K | 10.80% |
| VERONICA TICE4 | 2505 SPRINGBROOK DR. LAS VEGAS, NV 89134 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $530 | — | $530 | 23.60% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DR. TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $299 | — | $299 | 13.31% |
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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 559 | $3.1M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 473 | $369K |
| Vision | AETNA LIFE INSURANCE CO. | 559 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 473 | $214K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 473 | $171K |
| Prescription drug | AXIS INSURANCE COMPANY | 23 | $22K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 337 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 559 | — |
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.