| 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. | $87K | — | $87K | 6.38% |
| 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 | $2K | $17K | 8.59% |
| 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 | $343 | — | $343 | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $11K | — | $11K | 6.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | — | $203 | $203 | 0.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | AFLAC | $1K | — | $1K | 4.43% |
| FELICIA A. DOMINGUEZ3 | 6100 CENTER DR. SUITE 670 LOS ANGELES, CA 90045 | AFLAC | $788 | — | $788 | 3.15% |
| DENNY P. TWIGG3 | 24405 CHESTNUT ST. SUITE 103 SANTA CLARITA, CA 91321 | AFLAC | $744 | — | $744 | 2.98% |
| MARGARET VAIL3 | 1320 E. CALIFORNIA BLVD. PASADENA, CA 91106 | AFLAC | $637 | — | $637 | 2.55% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $298 | — | $298 | 1.19% |
| ART K. OKUN3 | 16153 SAN FERNANDO MISSION BLVD. GRANADA HILLS, CA 91344 | AFLAC | $254 | — | $254 | 1.02% |
| MICHAEL R. FISHER3 | 337 S. ALMANSOR ST. APT. F ALHAMBRA, CA 91801 | AFLAC | $248 | — | $248 | 0.99% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $190 | — | $190 | 0.76% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LN. LOS ANGELES, CA 90049 | AFLAC | $123 | — | $123 | 0.49% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE AND COMPANY INC. | P.O. BOX 70 SANTA MONICA, CA 90406 | AFLAC | $117 | — | $117 | 0.47% |
| EDDIE DEVOLD & ASSOCIATES3 | 10736 JEFFERSON BLVD. UNIT 119 CULVER CITY, CA 90230 | AFLAC | $113 | — | $113 | 0.45% |
| LAURA SEITZ3 | 2601 PURDUE AVE. LOS ANGELES, CA 90064 | AFLAC | $54 | $17 | $71 | 0.28% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $66 | — | $66 | 0.26% |
| DONNA REEVE3 | 9 MAPLE AVE. KENTFIELD, CA 94904 | AFLAC | $58 | — | $58 | 0.23% |
| MICHAEL R. FISHER3 | 1 S. FAIR OAKS AVE. SUITE 200 PASADENA, CA 91105 | AFLAC | $57 | — | $57 | 0.23% |
| KRISTOPHER KEAHIOLALO3 | 725 KAPIOLANI BLVD. SUITE C302 HONOLULU, HI 96813 | AFLAC | $42 | $3 | $45 | 0.18% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE. LOS ANGELES, CA 90045 | AFLAC | $34 | — | $34 | 0.14% |
| LAURA O. LEE3 | 3515 E. OCEAN BLVD. APT. 9 LONG BEACH, CA 90803 | AFLAC | $32 | — | $32 | 0.13% |
| KENNETH G. BARCLAY3 | 1600 ARDMORE AVE. UNIT 424 HERMOSA BEACH, CA 90254 | AFLAC | $25 | $3 | $28 | 0.11% |
| MARK A. MUELLER3 | 4145 SHADOW LN. APT. 413 SANTA ROSA, CA 95405 | AFLAC | $17 | — | $17 | 0.07% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $17 | — | $17 | 0.07% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DR. CORONA, CA 92883 | AFLAC | $11 | — | $11 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK ST. SUITE 625 CHICAGO, IL 60654 | AFLAC | $10 | — | $10 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD. FAIRFIELD, CA 94534 | AFLAC | $8 | — | $8 | 0.03% |
| LABAN MATTHEW SPALDING3 | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $3 | — | $3 | 0.01% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 377 E. BUTTERFIELD RD. SUITE 210 LOMBARD, IL 60148 | AFLAC | $3 | — | $3 | 0.01% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $3 | — | $3 | 0.01% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PL. UNIT 18C NEW YORK, NY 10017 | AFLAC | $2 | — | $2 | 0.01% |
| VICTORIA L FLYNN3 Filed as: VICTORIA HOWARD | 1366 CAMINO PERAL UNIT A MORAGA, CA 94556 | AFLAC | $1 | — | $1 | 0.00% |
| L MATTHEW SPALDING3 Filed as: L. MATTHEW SPALDING | 4297 KLUMP AVE. STUDIO CITY, CA 91602 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD., SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 5.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 20.00% |
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 | 281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 235 | $1.6M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 283 | $224K |
| Vision | VISION SERVICE PLAN | 159 | $25K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 283 | $199K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 283 | $199K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 283 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.