| 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. | $68K | $2K | $70K | 6.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $9K | 12.33% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.07% |
| PCF INSURANCE SERVICES OF THE WEST3 | LLC 6200 CANOGA AVE., SUITE 325 WOODLAND HILLS, CA 91367 | AFLAC | $243 | — | $243 | 1.79% |
| JENNIFER KARSTING3 | 17671 COWAN SUITE 125 IRVINE, CA 92614 | AFLAC | $147 | — | $147 | 1.08% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LN. YORBA LINDA, CA 92886 | AFLAC | $128 | — | $128 | 0.94% |
| PHILLIP S GLEASON3 Filed as: PHILLIP S. GLEASON | 1234 N. LA BREA AVE. APT. 330 WEST HOLLYWOOD, CA 90038 | AFLAC | $106 | — | $106 | 0.78% |
| SUZETTE L. KARSTING3 | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $98 | — | $98 | 0.72% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $80 | — | $80 | 0.59% |
| PHILLIP S GLEASON3 Filed as: PHILLIP S. GLEASON | 1322 HAVENHURST DR. APT. 25 WEST HOLLYWOOD, CA 90046 | AFLAC | $70 | — | $70 | 0.52% |
| EXECUTIVE CONSULTANTS GROUP INC.3 | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $59 | — | $59 | 0.43% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS INC. | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $56 | — | $56 | 0.41% |
| STRATEGIC LIFE INSURANCE SERVICES3 | INC. 2400 MAIN ST., SUITE 200 IRVINE, CA 92614 | AFLAC | $52 | — | $52 | 0.38% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS INC. | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | AFLAC | $40 | — | $40 | 0.29% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 11739 HICKORY RUN CT. LOVELAND, OH 45140 | AFLAC | $26 | — | $26 | 0.19% |
| MARGARET HICKMAN3 | 5171 SANTA FE ST. YORBA LINDA, CA 92886 | AFLAC | $21 | — | $21 | 0.15% |
| MARISSA M. THORPE3 | 5331 DELONG ST. CYPRESS, CA 90630 | AFLAC | $20 | — | $20 | 0.15% |
| ASHLEY L. FELICIANO3 | 13124 DESTINO PL. CERRITOS, CA 90703 | AFLAC | $17 | — | $17 | 0.13% |
| JESSIE H. SANCHEZ3 | 4315 SALERNO DR. RIVERSIDE, CA 92503 | AFLAC | $14 | — | $14 | 0.10% |
| KRISTIN LEASE3 Filed as: KRISTIN D. LEASE | 3890 HOWARD AVE. LOS ALAMITOS, CA 90720 | AFLAC | $8 | — | $8 | 0.06% |
| JAMES J GRETHEL3 Filed as: JAMES J. GRETHEL | 865 CEDAR DR. LOVELAND, OH 45140 | AFLAC | $6 | — | $6 | 0.04% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON INC. | 2211 MICHELSON DR. SUITE 1150 IRVINE, CA 92612 | AFLAC | $6 | — | $6 | 0.04% |
| KERSTIN J VANZANTEN3 Filed as: KERSTIN J. VANZANTEN | 40152 STOWE RD. TEMECULA, CA 92591 | AFLAC | $5 | — | $5 | 0.04% |
| DALE IRA DAVIS3 | 5892 CEDARCREEK LN LEXINGTON, KY 40515 | AFLAC | $3 | — | $3 | 0.02% |
| OWEN JOHNSTON3 | 1231 W. 2ND ST. SANTA ANA, CA 92703 | AFLAC | $3 | — | $3 | 0.02% |
| ALYSSA JOAN GUBA3 | 15222 TAYLOR WAY TUSTIN, CA 92782 | AFLAC | $2 | — | $2 | 0.01% |
| NICHOLAS K. GREEN3 | 4276 KATELLA AVE. SUITE 185 LOS ALAMITOS, CA 90720 | 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 | $2K | $573 | $3K | 24.70% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $382 | $382 | 3.14% |
| FMLASOURCE INC5 Filed as: FMLASOURCE INC. | 455 N. CITYFRONT PLZ DR. 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 40.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $395 | $395 | 4.64% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $263 | $263 | 3.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $714 | $10 | $724 | 10.13% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $40 | $40 | 0.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | EYEMED VISION CARE | $556 | — | $556 | 9.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $583 | $310 | $893 | 15.31% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $206 | $206 | 3.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $529 | $239 | $768 | 14.53% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $160 | $160 | 3.03% |
| DAVID PAPERNO4 | 78347 GRAPE ARBOR AVE. PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $52 | — | $52 | 4.86% |
| KEN PAPERNO4 | 5247 SOUTHERN CYPRESS CT. NORTH LAS VEGAS, NV 89031 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $45 | — | $45 | 4.21% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 171 | $1.0M |
| Dental(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 94 | $96K |
| Vision | EYEMED VISION CARE | 176 | $6K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $21K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 46 | $19K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $5K |
| Other(4 contracts, 3 carriers) | AFLAC | 150 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.