| 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 AND AFFILIATES ('CIGNA') | $66K | $1K | $68K | 5.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $58K | $1K | $59K | 5.48% |
| HEINZ SCHULMEISTER3 | 13800 CANOE BROOK DR. APT. 15F SEAL BEACH, CA 90740 | AFLAC | $1K | — | $1K | 4.98% |
| DAWN A CHRISTENSEN3 Filed as: DAWN A. CHRISTENSEN | 24516 APPLE ST. NEWHALL, CA 91321 | AFLAC | $337 | — | $337 | 1.42% |
| JACOB BURNS INC.3 | 2905 MAGNOLIA AVE. LONG BEACH, CA 90806 | AFLAC | $283 | — | $283 | 1.19% |
| JOSEPH L. AGAGON3 | 3999 LEWIS AVE. LONG BEACH, CA 90807 | AFLAC | $144 | — | $144 | 0.61% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PL. UNIT 18C NEW YORK, NY 10017 | AFLAC | $91 | — | $91 | 0.38% |
| STEVEN R. JOHNSON3 | 6167 BRISTOL PKWY. SUITE 106 CULVER CITY, CA 90230 | AFLAC | $87 | — | $87 | 0.37% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LN. LOS ANGELES, CA 90049 | AFLAC | $78 | — | $78 | 0.33% |
| JANELLE M ZAMORA3 Filed as: JANELLE M. ZAMORA | 421 W. BROADWAY APT. 4157 LONG BEACH, CA 90802 | AFLAC | $73 | — | $73 | 0.31% |
| RANDI MARA RAWLINS3 | 3450 GREENFIELD AVE. LOS ANGELES, CA 90034 | AFLAC | $67 | — | $67 | 0.28% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 14747 N. NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $54 | — | $54 | 0.23% |
| KATRINA LAFATA3 | 2905 MAGNOLIA AVE. LONG BEACH, CA 90806 | AFLAC | $50 | — | $50 | 0.21% |
| BRYSTRA INSURANCE SERVICES3 Filed as: BRYSTRA INSURANCE SERVICES INC. | 1925 CENTURY PARK E. SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $37 | — | $37 | 0.16% |
| RUSSELL G LAKE JR3 Filed as: RUSSELL G. LAKE JR. | 29309 BEACHCOMBER DR. SUN CITY, CA 92585 | AFLAC | $29 | — | $29 | 0.12% |
| STEVEN R. JOHNSON3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $28 | — | $28 | 0.12% |
| DAVID HERNANDEZ3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $24 | — | $24 | 0.10% |
| KAREN M HUGHES3 Filed as: KAREN M. HUGHES | 3120 NE 47TH ST. FORT LAUDERDALE, FL 33308 | AFLAC | $22 | — | $22 | 0.09% |
| KARI S. TAMKE3 | 45 54TH PL. APT. 4 LONG BEACH, CA 90803 | AFLAC | $22 | — | $22 | 0.09% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 711 S. OLIVE ST. APT. 314 LOS ANGELES, CA 90014 | AFLAC | $21 | — | $21 | 0.09% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE. LOS ANGELES, CA 90045 | AFLAC | $19 | — | $19 | 0.08% |
| RENE CASTRO3 | 5460 E. EL PARQUE ST. LONG BEACH, CA 90815 | AFLAC | $16 | — | $16 | 0.07% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK ST. SUITE 615 CHICAGO, IL 60654 | AFLAC | $15 | — | $15 | 0.06% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE ST. TOLUCA LAKE, CA 91602 | AFLAC | $7 | — | $7 | 0.03% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVE. BARRINGTON, IL 60010 | AFLAC | $6 | — | $6 | 0.03% |
| ANNETTE L. BURNS3 | 28303 BRYCE DR. CASTAIC, CA 91384 | AFLAC | $4 | — | $4 | 0.02% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR. WALNUT CREEK, CA 94598 | AFLAC | $3 | — | $3 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H. WILLIS JR. | 1431 NE 55TH ST. FORT LAUDERDALE, FL 33334 | AFLAC | $3 | — | $3 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT ST. SUITE 800 SAN FRANCISICO, CA 94105 | AFLAC | $2 | — | $2 | 0.01% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 117 MORNING MIST LN. FRANKLIN, TN 37064 | AFLAC | $1 | — | $1 | 0.00% |
| BOLON & COMPANY3 | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $141 | $4K | 15.59% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $949 | $949 | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | VISION SERVICE PLAN | $1K | — | $1K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $126 | $3K | 15.58% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $870 | $870 | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $250 | $10 | $260 | 15.62% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $67 | $67 | 4.02% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 166 | 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 AND AFFILIATES ('CIGNA') | 162 | $2.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 146 | $1.2M |
| Vision | VISION SERVICE PLAN | 137 | $22K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 165 | $24K |
| Short-term disability | AFLAC | 26 | $24K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 165 | $22K |
| Other(2 contracts, 2 carriers) | AFLAC | 165 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.