| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OHM BENEFIT AND INSURANCE3 | SOLUTIONS 9576 TOPANGA CANYON BLVD. CHATSWORTH, CA 91311 | CALIFORNIA PHYSICIANS' SERVICE | $1 | $58K | $58K | 4.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $38K | $38K | 2.81% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 | 9301 CORBIN AVE. SUITE 1500 NORTHRIDGE, CA 913242508 | HUMANA INSURANCE COMPANY | $5K | — | $5K | 8.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 4.07% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 | 9301 CORBIN AVE. SUITE 1500 NORTHRIDGE, CA 913242508 | HUMANA DENTAL INSURANCE COMPANY | $1K | — | $1K | 7.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | HUMANA DENTAL INSURANCE COMPANY | $627 | — | $627 | 4.08% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE SERVICES | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $584 | — | $584 | 4.95% |
| RHOEL T VALDEZ3 Filed as: RHOEL T. VALDEZ | 20016 BLYTHE ST. WINNETKA, CA 91306 | AFLAC | $406 | $6 | $412 | 3.74% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT AND INSURANCE SOLUTIONS | 9301 CORBIN AVE. SUITE 1500 NORTHRIDGE, CA 91324 | AFLAC | $324 | — | $324 | 2.94% |
| ELLEN G VALDEZ3 Filed as: ELLEN G. VALDEZ | 20016 BLYTHE ST. WINNETKA, CA 91306 | AFLAC | $276 | $14 | $290 | 2.64% |
| DORA BOSTICK3 | 1620 S. DITMAR ST. OCEANSIDE, CA 92054 | AFLAC | $136 | — | $136 | 1.24% |
| KENNIESHA SHACOYE NEWSOME3 | 2235 JAMESTOWN LN OXNARD, CA 93035 | AFLAC | $99 | — | $99 | 0.90% |
| GINA MICHELLE VENTURINI3 | 5151 WOODMAN AVE. APT. 55 SHERMAN OAKS, CA 91423 | AFLAC | $83 | — | $83 | 0.75% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK | 1620 S. DITMAR ST. OCEANSIDE, CA 92054 | AFLAC | $76 | $6 | $82 | 0.75% |
| KATHLEEN ANDERSON3 | 5251 VINELAND AVE. APT. 403 NORTH HOLLYWOOD, CA 91601 | AFLAC | $46 | $14 | $60 | 0.55% |
| BRIAN KEITH GATLIN3 | 5252 BISHOP ST. APT. 1 CYPRESS, CA 90630 | AFLAC | $50 | — | $50 | 0.45% |
| ELLEN G VALDEZ3 Filed as: ELLEN G. VALDEZ | 4339 RADFORD AVE. APT. 4 STUDIO CITY, CA 91604 | AFLAC | $31 | — | $31 | 0.28% |
| KENNIESHA SHACOYE NEWSOME3 | 4565 W. MARTIN LUTHER KING JR. BLVD APT. 370 LOS ANGELES, CA 90016 | AFLAC | $23 | — | $23 | 0.21% |
| GINA MICHELLE VENTURINI3 | 10902 HARTSOOK ST. APT. 205 NORTH HOLLYWOOD, CA 91601 | AFLAC | $19 | — | $19 | 0.17% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE SERVICES | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $516 | — | $516 | 4.91% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE SERVICES | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $592 | — | $592 | 10.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $287 | — | $287 | 4.89% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE | SERVICES 19360 RINALDI ST., SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $282 | — | $282 | 10.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $138 | — | $138 | 4.93% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 114 | $1.3M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 122 | $75K |
| Vision(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 122 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 119 | $22K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 45 | $17K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 74 | $12K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 114 | $1.3M |
| Other(2 contracts, 2 carriers) | AFLAC | 119 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.