| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AETNA HEALTH, INC. | $67K | — | $67K | 6.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 7.85% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC. | 175 SOUTH THIRD STREET SUITE 800 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $98 | — | $98 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $7K | $1K | $8K | 7.48% |
| FELICIA A. DOMINGUEZ3 | 6100 CENTER DR. SUITE 670 LOS ANGELES, CA 90045 | AFLAC | $2K | $159 | $2K | 5.79% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $884 | $62 | $946 | 2.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AFLAC | $889 | — | $889 | 2.42% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $407 | $32 | $439 | 1.19% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BLVD. SUITE 1225 LOS ANGELES, CA 90025 | AFLAC | $267 | $42 | $309 | 0.84% |
| HELENE MCCARDLE3 | 355 S. MADISON AVE. UNIT 114 PASADENA, CA 91101 | AFLAC | $291 | — | $291 | 0.79% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE AND COMPANY INC. | P.O. BOX 70 SANTA MONICA, CA 90406 | AFLAC | $239 | — | $239 | 0.65% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $222 | $9 | $231 | 0.63% |
| LAURA O. LEE3 | 3515 E. OCEAN BLVD. APT. 9 LONG BEACH, CA 90803 | AFLAC | $193 | $32 | $225 | 0.61% |
| LAURA SEITZ3 | 3437 GREENFIELD AVE. LOS ANGELES, CA 90034 | AFLAC | $125 | — | $125 | 0.34% |
| DONNA REEVE3 | 9 MAPLE AVE. KENTFIELD, CA 94904 | AFLAC | $70 | — | $70 | 0.19% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DR. LOS ANGELES, CA 90045 | AFLAC | $52 | — | $52 | 0.14% |
| KRISTOPHER KEAHIOLALO3 | 11835 W. OLYMPIC BLVD. SUITE 795 LOS ANGELES, CA 90064 | AFLAC | $37 | — | $37 | 0.10% |
| DENNY P. TWIGG3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $30 | — | $30 | 0.08% |
| KENNETH G. BARCLAY3 | 1600 ARDMORE AVE. UNIT 424 HERMOSA BEACH, CA 90254 | AFLAC | $25 | — | $25 | 0.07% |
| MARK A. MUELLER3 | 4145 SHADOW LN. APT. 413 SANTA ROSA, CA 95405 | AFLAC | $20 | — | $20 | 0.05% |
| DENNY P. TWIGG3 | 24405 CHESTNUT ST. SUITE 103 SANTA CLARITA, CA 91321 | AFLAC | $15 | — | $15 | 0.04% |
| L MATTHEW SPALDING3 Filed as: L. MATTHEW SPALDING | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $14 | $1 | $15 | 0.04% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DR. CORONA, CA 92883 | AFLAC | $13 | — | $13 | 0.04% |
| KENNETH G. BARCLAY3 | 22028 COVELLO ST. CANOGA PARK, CA 91303 | AFLAC | $12 | — | $12 | 0.03% |
| CALIFORNIA EAST BAY INS SERV INC3 Filed as: CALIFORNIA EAST BAY INSURANCE | SERVICES INC. 2818 ROCKVILLE RD. FAIRFIELD, CA 94534 | AFLAC | $9 | — | $9 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $84 | $4K | 20.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 5.35% |
| WANGLIN, RONALD, CHASE3 | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $789 | — | $789 | 10.77% |
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT ADVISORS | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.22% |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 195 | $1.2M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 246 | $225K |
| Vision | VISION SERVICE PLAN | 142 | $22K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 246 | $189K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 11 | $7K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 246 | $189K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 246 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.