| 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 LIFE INSURANCE CO. | $153K | $19K | $172K | 6.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA HEALTH, INC. | $80K | — | $80K | 4.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $5K | — | $5K | 16.12% |
| LEIGH ANN GILMORE4 | 16332 SARATOGA LANE HUNTINGTON BEACH, CA 92649 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $1K | — | $1K | 14.17% |
| VERONICA TICE4 | 2695 BENGAL TAN AVENUE NORTH LAS VEGAS, NV 89086 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $158 | — | $158 | 2.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | AXIS INSURANCE COMPANY | $620 | — | $620 | 10.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | $11 | $222 | 7.39% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $3 | $20 | 0.67% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $3 | $17 | 0.57% |
| ANTOINETTE MARI GARCIA3 | 1745 ORANGEWOOR AVENUE SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $7 | $17 | 0.57% |
| NICHOLAS RYAN DERRICO3 | 1745 W. ORANGEWOOD AVENUE SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $4 | $10 | 0.33% |
| LUZ CASTILLO BARRIGA3 | 22019 JUAN AVENUE HAWAIIAN GARDENS, CA 90716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $1 | $7 | 0.23% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE SUITE 112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.20% |
| LAMBERT MONTALBO3 | 26197 MIRADA STREET HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.13% |
| JONATHAN MARK DAHL3 | 1722 DIXON STREET REDONDO BEACH, CA 90278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.07% |
| LAURA LETICIA RENOVA3 | 2048 AUDREY HEPBURN STREET LAS VEGAS, NV 89142 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| LILIANA RIVERA3 | 25671 TONADILLA CIRCLE MORENO VALLEY, CA 92551 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| JCASTELLANOS AND ASSOCIATES INC3 Filed as: JCASTELLANOS AND ASSOCIATES INC. | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
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 | 448 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 449 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 913 | $4.3M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 913 | $2.7M |
| Vision | AETNA LIFE INSURANCE CO. | 913 | $2.7M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 446 | $84K |
| Prescription drug(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 913 | $4.3M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 446 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 913 | — |
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.