| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $49K | $1K | $50K | 4.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $51K | $2K | $53K | 5.54% |
| HEINZ SCHULMEISTER3 | 2663 CENTINELA AVENUE UNIT 202 SANTA MONICA, CA 90405 | AFLAC | $3K | $22 | $3K | 7.44% |
| JACOB BURNS INC.3 | 12121 WILSHIRE BLVD. SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $503 | $4 | $507 | 1.47% |
| DAWN A CHRISTENSEN3 Filed as: DAWN CHRISTENSEN | 24516 APPLE STREET NEWHALL, CA 91321 | AFLAC | $503 | — | $503 | 1.45% |
| STEVE JOHNSON3 | 6167 BRISTOL PARKWAY SUITE 106 CULVER CITY, CA 90230 | AFLAC | $187 | — | $187 | 0.54% |
| JOSEPH L. AGAGON3 Filed as: JOSEPH AGAGON | 421 W. BROADWAY LONG BEACH, CA 90802 | AFLAC | $183 | — | $183 | 0.53% |
| OLENA K SHEA3 Filed as: OLENA SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $143 | — | $143 | 0.41% |
| ADAM H MICHAELS3 Filed as: ADAM MICHAELS | 12121 WILSHIRE BLVD. SUITE 1225 LOS ANGELES, CA 90025 | AFLAC | $143 | — | $143 | 0.41% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY JOHNSON JR | 711 S. OLIVE STREET APT. 314 LOS ANGELES, CA 90014 | AFLAC | $138 | $4 | $142 | 0.41% |
| JANELLE M ZAMORA3 Filed as: JANELLE ZAMORA | 421 W. BROADWAY APT. 4157 LOS ANGELES, CA 90802 | AFLAC | $128 | — | $128 | 0.37% |
| DAVID HERNANDEZ3 | 3848 W. CARSON STREET SUITE 110 TORRANCE, CA 90503 | AFLAC | $118 | — | $118 | 0.34% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH BUZZELO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $91 | — | $91 | 0.26% |
| RANDI MARA RAWLINS3 Filed as: RANDI RAWLINS | 3450 GREENFIELD AVENUE LOS ANGELES, CA 90034 | AFLAC | $90 | — | $90 | 0.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 45 FREMONT STREET SUITE 800 SAN FRANCISCO, CA 94105 | AFLAC | $46 | — | $46 | 0.13% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DRIVE LOS ANGELES, CA 90045 | AFLAC | $33 | — | $33 | 0.10% |
| RUSSELL G LAKE JR3 Filed as: RUSSELL LAKE JR | 29309 BEACHCOMBER DRIVE SUN CITY, CA 92585 | AFLAC | $29 | — | $29 | 0.08% |
| MICHAEL C WALKER3 Filed as: MICHAEL STACHOWIAK | 321 N. CLARK STREET SUITE 625 CHICAGO, IL 60654 | AFLAC | $27 | — | $27 | 0.08% |
| KAREN M HUGHES3 Filed as: KAREN HUGHES | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $22 | — | $22 | 0.06% |
| KARI S. TAMKE3 Filed as: KARI TAMKE | 45 54TH PLACE APT. 4 LONG BEACH, CA 90803 | AFLAC | $22 | — | $22 | 0.06% |
| RENE CASTRO3 | 5460 E. EL PARQUE STREET LONG BEACH, CA 90815 | AFLAC | $21 | — | $21 | 0.06% |
| GARY SCOTT NELLIS3 Filed as: GARY NELLIS | 10607 1/2 WOODBRIDGE STREET TOLUCA LAKE, CA 91602 | AFLAC | $9 | — | $9 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH WILLIS JR | 1431 NE 55TH STREET FORT LAUDERDALE, FL 33334 | AFLAC | $6 | — | $6 | 0.02% |
| JOSEPH P CALARCO3 Filed as: JOSEPH NASCA | 28081 W. MAPLE AVENEU BARRINGTON, IL 60010 | AFLAC | $6 | — | $6 | 0.02% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DRIVE WALNUT CREEK, CA 94596 | AFLAC | $4 | — | $4 | 0.01% |
| ANNETTE BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $4 | — | $4 | 0.01% |
| LARA K GRANDE3 Filed as: LARA GRANDE | 1022 WESTHAVEN BLVD. FRANKLIN, TN 37064 | AFLAC | $3 | — | $3 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $656 | $5K | 17.19% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $497 | $4K | 17.16% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $921 | $921 | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 5.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $282 | $41 | $323 | 17.20% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $75 | $75 | 3.99% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 157 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 157 | $1.1M |
| Vision | VISION SERVICE PLAN | 152 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 168 | $30K |
| Short-term disability | AFLAC | 39 | $35K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 168 | $23K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 157 | $1.1M |
| Other(2 contracts, 2 carriers) | AFLAC | 168 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.