| 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. | $64K | — | $64K | 6.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $29K | — | $29K | 4.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | $9K | $35K | 16.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $8K | — | $8K | 6.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 4.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 20.00% |
| MARGARET VAIL3 | 1320 E. CALIFORNIA BLVD. PASADENA, CA 91106 | AFLAC | $908 | $80 | $988 | 5.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. PASADENA, CA 91107 | AFLAC | $818 | — | $818 | 4.22% |
| FELICIA A. DOMINGUEZ3 | 6100 CENTER DRIVE SUITE 670 LOS ANGELES, CA 90045 | AFLAC | $459 | — | $459 | 2.37% |
| KEVIN MICHAEL NAGLE3 | 32 ESPERANZA AVENUE APT. F SIERRA MADRE, CA 91024 | AFLAC | $396 | $16 | $412 | 2.12% |
| MICHAEL R. FISHER3 | 50 W. LEMON AVENUE SUITE 2 MONROVIA, CA 91016 | AFLAC | $287 | $16 | $303 | 1.56% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $284 | — | $284 | 1.46% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE STREET SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $109 | — | $109 | 0.56% |
| DENNY P. TWIGG3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $93 | — | $93 | 0.48% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $78 | — | $78 | 0.40% |
| DONNA REEVE3 | 9 MAPLE AVENUE KENTFIELD, CA 94904 | AFLAC | $70 | — | $70 | 0.36% |
| SPALDING GROUP ENTERPRISES3 | 29404 QUAIL RUN DRIVE AGOURA HILLS, CA 91301 | AFLAC | $55 | — | $55 | 0.28% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE AND COMPANY INC. | P.O. BOX 70 SANTA MONICA, CA 90406 | AFLAC | $49 | — | $49 | 0.25% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVENUE LOS ANGELES, CA 90045 | AFLAC | $21 | — | $21 | 0.11% |
| MARK A. MUELLER3 | 4145 SHADOW LANE APT. 413 SANTA ROSA, CA 95405 | AFLAC | $20 | — | $20 | 0.10% |
| EDDIE DEVOLD & ASSOCIATES3 | 10736 JEFFERSON BLVD. UNIT 119 CULVER CITY, CA 90230 | AFLAC | $16 | — | $16 | 0.08% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DRIVE CORONA, CA 92883 | AFLAC | $13 | — | $13 | 0.07% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SSUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $12 | — | $12 | 0.06% |
| LAURA O. LEE3 | 1525 PINE CHASE PLACE HIGHLANDS RANCH, CO 80126 | AFLAC | $12 | — | $12 | 0.06% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $9 | — | $9 | 0.05% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK STREET SUITE 615 CHICAGO, IL 60654 | AFLAC | $7 | — | $7 | 0.04% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVENUE STUDIO CITY, CA 91602 | AFLAC | $6 | — | $6 | 0.03% |
| LABAN MATTHEW SPALDING3 | 29404 QUAIL RUN DRIVE AGOURA HILLS, CA 91301 | AFLAC | $4 | — | $4 | 0.02% |
| KRISTOPHER KEAHIOLALO3 | 725 KAPIOLANI BLVD. SUITE C302 HONOLULU, HI 96813 | AFLAC | $2 | — | $2 | 0.01% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $2 | — | $2 | 0.01% |
| LAURA O. LEE3 | 3515 E. OCEAN BLVD. APT. 9 LONG BEACH, CA 90803 | AFLAC | $1 | — | $1 | 0.01% |
| VICTORIA L FLYNN3 Filed as: VICTORIA HOWARD | 1365 CAMINO PERAL SUITE A MORAGA, CA 94556 | AFLAC | $1 | — | $1 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $681 | — | $681 | 19.08% |
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 | 261 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA HEALTH, INC. | 159 | $1.8M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $227K |
| Vision | VISION SERVICE PLAN | 160 | $24K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $208K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $208K |
| Other(4 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $251K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.