| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $71K | — | $71K | 5.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $608 | $9K | 10.75% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $695 | $695 | 0.86% |
| PHILLIP S GLEASON3 Filed as: PHILLIP S. GLEASON | 1322 HAVENHURST DR. APT. 25 WEST HOLLYWOOD, CA 90046 | AFLAC | $365 | $245 | $610 | 3.08% |
| PCF INSURANCE SERVICES OF THE WEST3 | LLC 6200 CANOGA AVE., SUITE 325 WOODLAND HILLS, CA 91367 | AFLAC | $484 | — | $484 | 2.44% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LN. YORBA LINDA, CA 92886 | AFLAC | $275 | $49 | $324 | 1.63% |
| JENNIFER KARSTING3 | 17671 COWAN SUITE 125 IRVINE, CA 92614 | AFLAC | $227 | — | $227 | 1.14% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $173 | $49 | $222 | 1.12% |
| SUZETTE L. KARSTING3 | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $151 | — | $151 | 0.76% |
| PHILLIP S GLEASON3 Filed as: PHILLIP S. GLEASON | 8222 DE LONGPRE AVE. APT. 4 WEST HOLLYWOOD, CA 90046 | AFLAC | $118 | — | $118 | 0.59% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS INC. | 1936 E. DEERE AVE. SUITE 115 SANTA ANA, CA 92705 | AFLAC | $109 | — | $109 | 0.55% |
| EXECUTIVE CONSULTANTS GROUP INC.3 | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $90 | — | $90 | 0.45% |
| STRATEGIC LIFE INSURANCE SERVICES3 | INC. 1936 E. DEERE AVE. SANTA ANA, CA 92705 | AFLAC | $60 | — | $60 | 0.30% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 11739 HICKORY RUN CT. LOVELAND, OH 45140 | AFLAC | $37 | — | $37 | 0.19% |
| ASHLEY L. FELICIANO3 | 13124 DESTINO PL. CERRITOS, CA 90703 | AFLAC | $34 | — | $34 | 0.17% |
| MARISSA M. THORPE3 | 5331 DELONG ST. CYPRESS, CA 90630 | AFLAC | $26 | — | $26 | 0.13% |
| JESSIE H. SANCHEZ3 | 4315 SALERNO DR. RIVERSIDE, CA 92503 | AFLAC | $23 | — | $23 | 0.12% |
| MARGARET HICKMAN3 | 5171 SANTA FE ST. YORBA LINDA, CA 92886 | AFLAC | $21 | — | $21 | 0.11% |
| KRISTIN LEASE3 Filed as: KRISTIN D. LEASE | 4550 LINCOLN AVE. UNIT 221 CYPRESS, CA 90630 | AFLAC | $11 | — | $11 | 0.06% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON INC. | 2211 MICHELSON DR. SUITE 1150 IRVINE, CA 92612 | AFLAC | $9 | — | $9 | 0.05% |
| JAMES J GRETHEL3 Filed as: JAMES J. GRETHEL | 865 CEDAR DR. LOVELAND, OH 45140 | AFLAC | $9 | — | $9 | 0.05% |
| KERSTIN J VANZANTEN3 Filed as: KERSTIN J. VANZANTEN | 40152 STOWE RD. TEMECULA, CA 92591 | AFLAC | $7 | — | $7 | 0.04% |
| OWEN JOHNSTON3 | 796 N. HART ST. ORANGE, CA 92867 | AFLAC | $5 | — | $5 | 0.03% |
| DALE I DAVIS3 Filed as: DALE I. DAVIS | 5892 CEDARCREEK LN LEXINGTON, KY 40515 | AFLAC | $4 | — | $4 | 0.02% |
| ALYSSA JOAN GUBA3 | 15222 TAYLOR WAY TUSTIN, CA 92782 | AFLAC | $2 | — | $2 | 0.01% |
| KERSTIN J VANZANTEN3 Filed as: KERSTIN J. VANZANTEN | 40152 STOWE ROAD TEMECULA, CA 92591 | AFLAC | $1 | — | $1 | 0.01% |
| NICHOLAS K. GREEN3 | 4195 N. VIKING WAY SUITE 120 LONG BEACH, CA 90808 | AFLAC | $1 | — | $1 | 0.01% |
| DALE I DAVIS3 Filed as: DALE I. DAVIS | 1856 TRAVELLER RD. LEXINGTON, KY 40504 | AFLAC | $1 | — | $1 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $233 | $3K | 21.72% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $199 | $199 | 1.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $124 | $1K | 11.20% |
| FMLASOURCE INC5 Filed as: FMLASOURCE INC. | 455 N. CITYFRONT PLZ DR. 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 38.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $211 | $211 | 2.36% |
| NATIONALL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $181 | $181 | 2.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $777 | $131 | $908 | 11.68% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $113 | $113 | 1.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | EYEMED | $704 | — | $704 | 9.15% |
| PETER C. FOY & ASSOCIATES3 | INSURANCE SERVICES 6200 CANOGA AVE., SUITE 325 WOODLAND HILLS, CA 91367 | EYEMED | $67 | — | $67 | 0.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $545 | $97 | $642 | 11.77% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $83 | $83 | 1.52% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 205 | $1.3M |
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $91K |
| Vision | EYEMED | 200 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $22K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $8K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 105 | $5K |
| Other(3 contracts, 2 carriers) | AFLAC | 163 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.