| 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. | $70K | $2 | $70K | 5.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $67K | $7 | $67K | 5.47% |
| BOLON & COMPANY3 | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $283 | $4K | 16.07% |
| 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 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $268 | $4K | 15.83% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $966 | $966 | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | VISION SERVICE PLAN | $1K | — | $1K | 5.31% |
| HEINZ SCHULMEISTER3 | 13800 CANOE BROOK DR. APT. 15F SEAL BEACH, CA 90740 | AFLAC | $917 | — | $917 | 4.47% |
| ANNETTE L. BURNS3 | 28303 BRYCE DR. CASTAIC, CA 91384 | AFLAC | $486 | — | $486 | 2.37% |
| DAWN A CHRISTENSEN3 Filed as: DAWN A. CHRISTENSEN | 24516 APPLE ST. NEWHALL, CA 91321 | AFLAC | $299 | — | $299 | 1.46% |
| JACOB BURNS INC.3 | 2905 MAGNOLIA AVE. LONG BEACH, CA 90806 | AFLAC | $227 | — | $227 | 1.11% |
| JOSEPH L. AGAGON3 | 3999 LEWIS AVE. LONG BEACH, CA 90807 | AFLAC | $123 | — | $123 | 0.60% |
| STEVEN R. JOHNSON3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $97 | — | $97 | 0.47% |
| JANELLE M ZAMORA3 Filed as: JANELLE M. ZAMORA | 421 W. BROADWAY APT. 4157 LONG BEACH, CA 90802 | AFLAC | $67 | — | $67 | 0.33% |
| RANDI MARA RAWLINS3 | 3450 GREENFIELD AVE. LOS ANGELES, CA 90034 | AFLAC | $61 | — | $61 | 0.30% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PL. UNIT 18C NEW YORK, NY 10017 | AFLAC | $57 | — | $57 | 0.28% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $56 | — | $56 | 0.27% |
| GEORGE E ARBID3 Filed as: GEORGE E. ARBID | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $52 | — | $52 | 0.25% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 14747 N. NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $47 | — | $47 | 0.23% |
| KATRINA LAFATA3 | 2905 MAGNOLIA AVE. LONG BEACH, CA 90806 | AFLAC | $46 | — | $46 | 0.22% |
| RUSSELL G LAKE JR3 Filed as: RUSSELL G. LAKE JR. | 26025 NEWPORT RD. SUITE A 545 MENIFEE, CA 92584 | AFLAC | $26 | — | $26 | 0.13% |
| DAVID HERNANDEZ3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $22 | — | $22 | 0.11% |
| KAREN M HUGHES3 Filed as: KAREN M. HUGHES | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $20 | — | $20 | 0.10% |
| KARI S. TAMKE3 | 45 54TH PL. APT. 4 LONG BEACH, CA 90803 | AFLAC | $20 | — | $20 | 0.10% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 711 S. OLIVE ST. APT. 314 LOS ANGELES, CA 90014 | AFLAC | $19 | — | $19 | 0.09% |
| DAVID BRYANT3 | 1925 CENTURY PARK E. SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $19 | — | $19 | 0.09% |
| BRYSTRA INSURANCE SERVICES3 Filed as: BRYSTRA INSURANCE SERVICES INC. | 1925 CENTURY PARK E. SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $16 | — | $16 | 0.08% |
| RENE CASTRO3 | 5460 E. EL PARQUE ST. LONG BEACH, CA 90815 | AFLAC | $13 | — | $13 | 0.06% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE. LOS ANGELES, CA 90045 | AFLAC | $12 | — | $12 | 0.06% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT ST. SUITE 800 SAN FRANCISCO, CA 94105 | AFLAC | $9 | — | $9 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK ST. SUITE 615 CHICAGO, IL 60654 | AFLAC | $9 | — | $9 | 0.04% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE ST. TOLUCA LAKE, CA 91602 | AFLAC | $6 | — | $6 | 0.03% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVE. BARRINGTON, IL 60010 | AFLAC | $5 | — | $5 | 0.02% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR. WALNUT CREEK SAN FRANCISICO, 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 | $2 | — | $2 | 0.01% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 117 MORNING MIST LN. FRANKLIN, TN 37064 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HOLMAN FAMILY COUNSELING, INC. | $104 | — | $104 | 4.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $283 | $20 | $303 | 16.55% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2 | $73 | $75 | 4.10% |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 181 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 144 | $1.2M |
| Vision | VISION SERVICE PLAN | 141 | $22K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 171 | $27K |
| Short-term disability | AFLAC | 25 | $21K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 171 | $24K |
| Other(3 contracts, 3 carriers) | AFLAC | 174 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.