| 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. | $75K | — | $75K | 6.42% |
| 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 | 7.56% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $138 | — | $138 | 0.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $9K | — | $9K | 6.37% |
| FELICIA A. DOMINGUEZ3 | 6100 CENTER DR. SUITE 670 LOS ANGELES, CA 90045 | AFLAC | $1K | $43 | $1K | 4.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AFLAC | $840 | — | $840 | 2.71% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $445 | $26 | $471 | 1.52% |
| LAURA SEITZ3 | 3437 GREENFIELD AVE. LOS ANGELES, CA 90034 | AFLAC | $323 | — | $323 | 1.04% |
| DENNY P. TWIGG3 | 24405 CHESTNUT ST. SUITE 103 SANTA CLARITA, CA 91321 | AFLAC | $296 | — | $296 | 0.96% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $280 | — | $280 | 0.90% |
| LAURA SEITZ3 | 2601 PURDUE AVE. LOS ANGELES, CA 90064 | AFLAC | $248 | — | $248 | 0.80% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BLVD. SUITE 1225 LOS ANGELES, CA 90025 | AFLAC | $175 | — | $175 | 0.56% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE AND COMPANY INC. | P.O. BOX 70 APT. 9 SANTA MONICA, CA 90406 | AFLAC | $167 | — | $167 | 0.54% |
| KENNETH G. BARCLAY3 | 1600 ARDMORE AVE. UNIT 424 HERMOSA BEACH, CA 90254 | AFLAC | $162 | — | $162 | 0.52% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $113 | $15 | $128 | 0.41% |
| KRISTOPHER KEAHIOLALO3 | 11835 W. OLYMPIC BLVD. SUITE 795 LOS ANGELES, CA 90064 | AFLAC | $122 | — | $122 | 0.39% |
| HELENE MCCARDLE3 | 355 S. MADISON AVE. UNIT 114 PASADENA, CA 91101 | AFLAC | $26 | $63 | $89 | 0.29% |
| DONNA REEVE3 | 9 MAPLE AVE. KENTFIELD, CA 94904 | AFLAC | $64 | — | $64 | 0.21% |
| LAURA O. LEE3 | 3515 E. OCEAN BLVD. APT. 9 LONG BEACH, CA 90803 | AFLAC | $50 | $9 | $59 | 0.19% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DR. LOS ANGELES, CA 90045 | AFLAC | $49 | $9 | $58 | 0.19% |
| KRISTOPHER KEAHIOLALO3 | 725 KAPIOLANI BLVD. SUITE C302 HONOLULU, HI 96813 | AFLAC | $40 | — | $40 | 0.13% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $24 | — | $24 | 0.08% |
| MARK A. MUELLER3 | 4145 SHADOW LN APT. 413 SANTA ROSA, CA 95405 | AFLAC | $19 | — | $19 | 0.06% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 317 MARKET ST. ROCKFORD, IL 61107 | AFLAC | $15 | — | $15 | 0.05% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DR. CORONA, CA 92883 | AFLAC | $12 | — | $12 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 12121 WILSHIRE BLVD. LOS ANGELES, CA 90025 | AFLAC | $10 | — | $10 | 0.03% |
| CALIFORNIA EAST BAY INS SERV INC3 Filed as: CALIFORNIA EAST BAY INS. SERV. INC. | 2818 ROCKVILLE RD. FAIRFIELD, CA 94534 | AFLAC | $5 | — | $5 | 0.02% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD. FAIRFIELD, CA 94534 | AFLAC | $4 | — | $4 | 0.01% |
| L MATTHEW SPALDING3 | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $4 | — | $4 | 0.01% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $2 | — | $2 | 0.01% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 377 E. BUTTERFIELD RD. SUITE 210 .OMBARD, IL 60148 | AFLAC | $2 | — | $2 | 0.01% |
| VICTORIA L FLYNN3 Filed as: VICTORIA HOWARD | 1385 CAMINO PERAL APT. A MORAGA, CA 94556 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 19.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 4.89% |
| WANGLIN, RONALD, CHASE3 | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 15.77% |
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT ADVISORS | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 1.00% |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 211 | $1.4M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 260 | $229K |
| Vision | VISION SERVICE PLAN | 153 | $24K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 260 | $198K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 11 | $8K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 260 | $198K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 260 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.