| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $82K | $22 | $82K | 5.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $75K | — | $75K | 5.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $7K | 17.84% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 3.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $923 | $6K | 17.92% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 3 PARKWAY NORTH SUITE 500 DEERFIELD, IL 60015 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | VISION SERVICE PLAN | $898 | — | $898 | 3.88% |
| IMA, INC.3 | P.O. BOX 102833 PASADENA, CA 91189 | VISION SERVICE PLAN | $557 | — | $557 | 2.41% |
| JULIE S KRAUS3 Filed as: JULIE S. KRAUS | 15066 VARSITY ST. APT. B MOORPARK, CA 93021 | AFLAC | $973 | — | $973 | 5.00% |
| HEINZ SCHULMEISTER3 | 13800 CANOE BROOK DR. APT. 15F SEAL BEACH, CA 90740 | AFLAC | $787 | — | $787 | 4.04% |
| DAWN A CHRISTENSEN3 Filed as: DAWN A. CHRISTENSEN | 24516 APPLE ST. NEWHALL, CA 91321 | AFLAC | $268 | — | $268 | 1.38% |
| CN BENEFITS INC3 Filed as: CN BENEFITS INC. | 4011 SAN LUIS ST. NEWBURY PARK, CA 91320 | AFLAC | $243 | — | $243 | 1.25% |
| ANNETTE BURNS3 | 28303 BRYCE DR. CASTAIC, CA 91384 | AFLAC | $159 | — | $159 | 0.82% |
| BRADLEY IAN WITT3 | 1621 RIDGEWOOD DR. CAMARILLO, CA 93012 | AFLAC | $155 | — | $155 | 0.80% |
| JACOB BURNS INC.3 | 2905 MAGNOLIA AVE. LONG BEACH, CA 90806 | AFLAC | $155 | — | $155 | 0.80% |
| JOSEPH L. AGAGON3 | 3999 LEWIS AVE. LONG BEACH, CA 90807 | AFLAC | $138 | — | $138 | 0.71% |
| STEVEN R. JOHNSON3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $99 | — | $99 | 0.51% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PL UNIT 18C NEW YORK, NY 10017 | AFLAC | $60 | — | $60 | 0.31% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $59 | — | $59 | 0.30% |
| JANELLE M ZAMORA3 Filed as: JANELLE M. ZAMORA | 421 W. BROADWAY APT. 4157 LONG BEACH, CA 90802 | AFLAC | $32 | — | $32 | 0.16% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 14747 N. NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $27 | — | $27 | 0.14% |
| GEORGE E ARBID3 Filed as: GEORGE E. ARBID | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $27 | — | $27 | 0.14% |
| DAVID HERNANDEZ3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $24 | — | $24 | 0.12% |
| RANDI MARA RAWLINS3 | 3450 GREENFIELD AVE. LOS ANGELES, CA 90034 | AFLAC | $24 | — | $24 | 0.12% |
| KARI S. TAMKE3 | 45 54TH PL APT. 4 LONG BEACH, CA 90803 | AFLAC | $22 | — | $22 | 0.11% |
| CHRISTOPHER HAGER3 | 44 COLONIAL DR. RANCHO MIRAGE, CA 92270 | AFLAC | $13 | — | $13 | 0.07% |
| RENE CASTRO3 | 5460 E. EL PARQUE ST. LONG BEACH, CA 90815 | AFLAC | $13 | — | $13 | 0.07% |
| USI INSURANCE SERVICES LLC3 | 575 MARKET ST. SUITE 3750 SAN FRANCISCO, CA 94105 | AFLAC | $10 | — | $10 | 0.05% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 711 S. OLIVE ST. APT. 314 LOS ANGELES, CA 90014 | AFLAC | $9 | — | $9 | 0.05% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK ST. SUITE 615 CHICAGO, IL 60654 | AFLAC | $9 | — | $9 | 0.05% |
| DAVID BRYANT3 | 1925 CENTURY PARK E SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $8 | — | $8 | 0.04% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE ST. TOLUCA LAKE, CA 91602 | AFLAC | $7 | — | $7 | 0.04% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVE. BARRINGTON, IL 60010 | AFLAC | $6 | — | $6 | 0.03% |
| KATRINA LAFATA3 | 2905 MAGNOLIA AVE. LONG BEACH, CA 90806 | AFLAC | $6 | — | $6 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H. WILLIS JR. | 1431 NE 55TH ST. FORT LAUDERDALE, FL 33334 | AFLAC | $2 | — | $2 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR. WALNUT CREEK, CA 94598 | AFLAC | $1 | — | $1 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $314 | $16 | $330 | 15.74% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $63 | $63 | 3.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | HOLMAN FAMILY COUNSELING, INC. | $104 | — | $104 | 4.98% |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 187 | $2.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 144 | $1.4M |
| Vision | VISION SERVICE PLAN | 142 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $39K |
| Short-term disability | AFLAC | 23 | $19K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $32K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 187 | $2.9M |
| Other(3 contracts, 3 carriers) | AFLAC | 183 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.