| 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. | $84K | $5K | $89K | 3.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $26K | $10K | $35K | 13.83% |
| ANNETTE L. BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $4K | $117 | $4K | 6.03% |
| JACOB BURNS INC.3 | 12121 WILSHIRE BLVD. SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $1K | $26 | $1K | 1.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $657 | — | $657 | 0.91% |
| JEFFREY C. BOYKINS3 | P.O. BOX 2917 WINNETKA, CA 91396 | AFLAC | $485 | — | $485 | 0.67% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR | 711 S. OLIVE STREET APT. 314 LOS ANGELES, CA 90014 | AFLAC | $395 | $29 | $424 | 0.59% |
| RENE CASTRO3 | 5460 E. EL PARQUE STREET LONG BEACH, CA 90815 | AFLAC | $388 | — | $388 | 0.54% |
| JACOB BURNS INC.3 | 11637 GORHAM AVENUE APT. 106 LOS ANGELES, CA 90049 | AFLAC | $248 | $3 | $251 | 0.35% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $222 | — | $222 | 0.31% |
| EDUARDO GUEDEA SR3 Filed as: EDUARDO GUEDA SR | 816 BROOKS AVENUE VENICE, CA 90291 | AFLAC | $215 | — | $215 | 0.30% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $213 | — | $213 | 0.29% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVENUE CARLSBAD, CA 92011 | AFLAC | $163 | — | $163 | 0.23% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE STREET SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $160 | — | $160 | 0.22% |
| LAURA CORRAL3 | 1211 S. CATALINA STREET APT. 1 LOS ANGELES, CA 90006 | AFLAC | $158 | — | $158 | 0.22% |
| GUY M. WELCH3 | 5414 MERCEDES AVENUE DALLAS, TX 75206 | AFLAC | $139 | — | $139 | 0.19% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $122 | — | $122 | 0.17% |
| JENNY ROSENBAUM3 Filed as: JENNY A. ROSENBAUM | 21 TROFELLO LANE ALISO VIEJO, CA 92656 | AFLAC | $103 | — | $103 | 0.14% |
| BILLY MCNEIL3 | 27068 CHANNEL LANE VALENCIA, CA 91355 | AFLAC | $90 | — | $90 | 0.12% |
| NEVIN VACHEL MCFARLAND3 | 3712 MONTCLAIR STREET LOS ANGELES, CA 90018 | AFLAC | $74 | $12 | $86 | 0.12% |
| ANA MARIA BACKNER3 | 30 LA ENCINA NEWBURY PARK, CA 91320 | AFLAC | $70 | — | $70 | 0.10% |
| DAWN A CHRISTENSEN3 Filed as: DAWN A. CHRISTENSEN | 24516 APPLE STREET NEWHALL, CA 91321 | AFLAC | $68 | — | $68 | 0.09% |
| ELIZABETH MICAELA VEGA3 | 11671 STRATHERN STREET NORTH HOLLYWOOD, CA 91605 | AFLAC | $64 | — | $64 | 0.09% |
| MAYNARD M. YOUNG3 | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $57 | — | $57 | 0.08% |
| HORACIO J. LANZAS3 | 7035 BAIRD AVENUE RESEDA, CA 91335 | AFLAC | $40 | $15 | $55 | 0.08% |
| DAVID J REESOR3 Filed as: DAVID J. REESOR | 2220 E. ROUTE 66 SUITE 215 GLENDORA, CA 91740 | AFLAC | $48 | — | $48 | 0.07% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVENUE LOS ANGELES, CA 90045 | AFLAC | $46 | — | $46 | 0.06% |
| BARBARA BARNETT3 | 1411 N. GRAND OAKS AVENUE PASADENA, CA 91104 | AFLAC | $39 | — | $39 | 0.05% |
| SETH JAFFE3 | 4127 E. MASSACHUSETTS STREET LONG BEACH, CA 90814 | AFLAC | $36 | — | $36 | 0.05% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK STREET SUITE 625 CHICAGO, IL 60654 | AFLAC | $29 | — | $29 | 0.04% |
| DAVID JACOB HOLPER3 | 22937 ARLINGTON AVENUE SUITE 102 TORRANCE, CA 90501 | AFLAC | $29 | — | $29 | 0.04% |
| DAVID M COUGHLIN3 Filed as: DAVID M. COUGHLIN | 10160 BRISTOL DRIVE RANCHO CUCAMONGA, CA 91737 | AFLAC | $22 | — | $22 | 0.03% |
| DON C. JONES3 | 706 OAKDALE AVENUE MONROVIA, CA 91016 | AFLAC | $20 | — | $20 | 0.03% |
| SHELIA H. HARTMAN3 | 22801 VENTURA BLVD. SUITE 205 WOODLAND HILLS, CA 91365 | AFLAC | $20 | — | $20 | 0.03% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVENUE BARRINGTON, IL 60010 | AFLAC | $18 | — | $18 | 0.02% |
| LESLIE R WOODS3 Filed as: LESLIE R. WOODS | 623 SPIRIT LAKE HIGHWAY CASTLE ROCK, WA 98611 | AFLAC | $18 | — | $18 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $18 | — | $18 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H. WILLIS JR | 1431 NE 55TH STREET FORT LAUDERDALE, FL 33334 | AFLAC | $14 | — | $14 | 0.02% |
| CLAY W CAMPBELL3 Filed as: CLAY CAMPBELL | 14720 LIBLEN AVENUE BELLFLOWER, CA 90706 | AFLAC | $12 | — | $12 | 0.02% |
| DONNA E. SINCLAIR3 | 16611 VICTORY BLVD. APT. 315 VAN NUYS, CA 91406 | AFLAC | $11 | — | $11 | 0.02% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE STREET TOLUCA LAKE, CA 91602 | AFLAC | $9 | — | $9 | 0.01% |
| ROXANNE C. BICKHAM3 | 10350 BASELINE ROAD SPACE 40 RANCHO CUCAMONGA, CA 91701 | AFLAC | $9 | — | $9 | 0.01% |
| JOSEPH P CALARCO3 Filed as: JOSEPH EVANS | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | AFLAC | $8 | — | $8 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $8 | — | $8 | 0.01% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 377 E. BUTTERFIELD ROAD SUITE 210 LOMBARD, IL 60148 | AFLAC | $8 | — | $8 | 0.01% |
| DAVID ANDREW PEPIN3 | 10000 N. 31ST AVENUE SUITE C107 PHOENIX, AZ 85051 | AFLAC | $8 | — | $8 | 0.01% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $7 | — | $7 | 0.01% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 1022 WESTHAVEN BLVD. FRANKLIN, TN 37064 | AFLAC | $6 | — | $6 | 0.01% |
| DAVID SMITH3 Filed as: DAVID MATTHEW SMITH | 2220 E. ROUTE 66 SUITE 215 GLENDORA, CA 91740 | AFLAC | $6 | — | $6 | 0.01% |
| KAREN M HUGHES3 Filed as: KAREN M. HUGHES | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $6 | — | $6 | 0.01% |
| DAVID ANDREW PEPIN3 | 9341 FORT BAYARD AVENUE LAS VEGAS, NV 89178 | AFLAC | $5 | — | $5 | 0.01% |
| DEBBIE L. PAPISH3 | 2907 CARRIAGE WAY WEST LINN, OR 97068 | AFLAC | $4 | — | $4 | 0.01% |
| DOUGLAS MEIER3 | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $4 | — | $4 | 0.01% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVENUE STUDIO CITY, CA 91602 | AFLAC | $4 | — | $4 | 0.01% |
| MARSHALL CHARLES MCDONALD3 | 415 DAVIDSON GATEWAY DRIVE APT. 7 DAVIDSON, NC 28036 | AFLAC | $3 | — | $3 | 0.00% |
| RONALD I MARTINDALE3 Filed as: RONALD I. MARTINDALE | 1242 N. SAN DIMAS CANYON ROAD SAN DIMAS, CA 91773 | AFLAC | $3 | — | $3 | 0.00% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 1840 VIA DEL REY SOUTH PASADENA, CA 91030 | AFLAC | $3 | — | $3 | 0.00% |
| TODD J BURKE CORP3 Filed as: TODD J. BURKE | 1 SEAPORT PLACE 23RD FLOOR NEW YORK, NY 10038 | AFLAC | $2 | — | $2 | 0.00% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 11177 JASMINE DRIVE ROSCOE, IL 61073 | AFLAC | $2 | — | $2 | 0.00% |
| ALL FOUR SEASONS INC.3 | 1464 MADERA ROAD N-228 SIMI VALLEY, CA 93065 | AFLAC | $2 | — | $2 | 0.00% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE M. LUCZAJ | 1201 MAIN STREET SUITE 2300 COLUMBIA, SC 29201 | AFLAC | $1 | — | $1 | 0.00% |
| LIVIER MARIA RAMIREZ3 | 1107 FAIR OAKS AVENUE UNIT 882 SOUTH PASADENA, CA 91030 | AFLAC | $1 | — | $1 | 0.00% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $1 | — | $1 | 0.00% |
| TODD V MASON3 Filed as: TODD V. MASON | 6164 LAWRENCE STREET CYPRESS, CA 90630 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL R. FISHER3 | 3201 WILSHIRE BLVD. SUITE 102 SANTA MONICA, CA 90403 | AFLAC | $1 | — | $1 | 0.00% |
| JOANA G. MATHERLY3 | 2000 GLEN ECHO ROAD SUITE 204 NASHVILLE, TN 37215 | AFLAC | $1 | — | $1 | 0.00% |
| MEGHAN MILLER3 | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | AFLAC | $1 | — | $1 | 0.00% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 1174 MORNING MIST LANE FRANKLIN, TN 37064 | AFLAC | $1 | — | $1 | 0.00% |
| PRAW INSURANCE SERVICES3 | 14011 VENTURA BLVD. SUITE 215 W SHERMAN OAKS, CA 91423 | AFLAC | $1 | — | $1 | 0.00% |
| SHANE DAVISON3 Filed as: SHANE CRAIG DAVIDSON | 120 PROVIDENCE TRL APT. 1200 MOUNT JULIET, TN 37122 | AFLAC | $1 | — | $1 | 0.00% |
| KARLA M. TOMAS1 Filed as: KARLA M. THOMAS | 516 S. VIA MONTANA BURBANK, CA 91501 | AFLAC | $1 | — | $1 | 0.00% |
| DE VITA B MCKENZIE3 Filed as: DE VITA B. MCKENZIE | 110 SE 6TH STREET SUITE 1700 SORT LAUDERDALE, FL 33301 | AFLAC | $1 | — | $1 | 0.00% |
| ANNE MARIE HUBBARD3 | 5138 RESIDENCIA NEWPORT BEACH, CA 92660 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 19.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC. | $3K | $1K | $4K | 12.85% |
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 | 285 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 425 | $2.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 873 | $287K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 873 | $257K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 873 | $329K |
| Short-term disability | AFLAC | 91 | $72K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 425 | $2.3M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 873 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 873 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.