| 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. | $54K | $1K | $55K | 5.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 7.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $286 | — | $286 | 0.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $614 | $2K | 22.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $383 | — | $383 | 4.60% |
| FMLASOURCE INC5 Filed as: FMLASOURCE INC. | 455 N. CITYFRONT PLZ DR. 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 39.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $508 | $508 | 6.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $524 | $239 | $763 | 10.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $128 | — | $128 | 1.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $637 | — | $637 | 10.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $12 | $12 | 0.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $448 | $344 | $792 | 13.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $140 | — | $140 | 2.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $367 | $305 | $672 | 13.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $115 | — | $115 | 2.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $522 | $144 | $666 | 14.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $160 | — | $160 | 3.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $284 | $89 | $373 | 15.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $83 | — | $83 | 3.39% |
| DAVID PAPERNO4 | 78347 GRAPE ARBOR AVE. PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $317 | — | $317 | 21.94% |
| PCF INSURANCE SERVICES OF THE WEST3 | LLC 21300 VICTORY BLVD, SUITE 700 WOODLAND HILLS, CA 91367 | AFLAC | $19 | — | $19 | 1.74% |
| PHILLIP S GLEASON3 Filed as: PHILLIP S. GLEASON | 1234 N. LA BREA AVE. APT. 330 WEST HOLLYWOOD, CA 90038 | AFLAC | $14 | — | $14 | 1.28% |
| JENNIFER KARSTING3 | 17671 COWAN SUITE 125 IRVINE, CA 92614 | AFLAC | $11 | — | $11 | 1.01% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LN. YORBA LINDA, CA 92886 | AFLAC | $9 | — | $9 | 0.83% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS INC. | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | AFLAC | $8 | — | $8 | 0.73% |
| SUZETTE L. KARSTING3 | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $8 | — | $8 | 0.73% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $6 | — | $6 | 0.55% |
| STRATEGIC LIFE INSURANCE3 Filed as: STRATEGIC LIFE INS. SERVICES INC. | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | AFLAC | $5 | — | $5 | 0.46% |
| EXECUTIVE CONSULTANTS GROUP INC.3 | 1936 E. DEERE AVE. SUITE 215 SANTA ANA, CA 92705 | AFLAC | $5 | — | $5 | 0.46% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 11739 HICKORY RUN CT. LOVELAND, OH 45140 | AFLAC | $2 | — | $2 | 0.18% |
| MARGARET HICKMAN3 | 32343 HILLSTONE ST. TEMECULA, CA 92591 | AFLAC | $2 | — | $2 | 0.18% |
| MARISSA M. THORPE3 | 5331 DELONG ST. CYPRESS, CA 90630 | AFLAC | $2 | — | $2 | 0.18% |
| ASHLEY L. FELICIANO3 | 13124 DESTINO PL. CERRITOS, CA 90703 | AFLAC | $1 | — | $1 | 0.09% |
| JESSIE H. SANCHEZ3 | 4315 SALERNO DR. RIVERSIDE, CA 92503 | AFLAC | $1 | — | $1 | 0.09% |
| JAMES J GRETHEL3 Filed as: JAMES J. GRETHEL | 865 CEDAR DR. LOVELAND, OH 45140 | AFLAC | $1 | — | $1 | 0.09% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 132 | $1.1M |
| Dental(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 72 | $70K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $7K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $17K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 41 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $5K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 132 | $1.1M |
| Other(6 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.