| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $81K | — | $81K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | — | $11K | 3.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $21K | — | $21K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 3.81% |
| KATHY DUFFY INSURANCE SERVICES3 | 10442 ORMOND ST. SHADOW HILLS, CA 91040 | AFLAC | $842 | $184 | $1K | 5.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $461 | — | $461 | 2.39% |
| VICKY H KRESINSKE3 Filed as: VICKY H. KRESINSKE | P.O. BOX 55322 VIRGINIA BEACH, VA 23471 | AFLAC | $423 | — | $423 | 2.19% |
| TWILA D SHOWALTER3 Filed as: TWILA D. SHOWALTER | 2515 E. MARKET ST. SUITE E HARRISONBURG, VA 22801 | AFLAC | $164 | — | $164 | 0.85% |
| KHACHATOUR MANOUKIAN3 Filed as: KHACHATOUR CHRIS MANOUKIAN | 221 N. BELMONT STREET APT. 7 GLENDALE, CA 91206 | AFLAC | $125 | $37 | $162 | 0.84% |
| MICHELLE C. LEE3 | 1044 LOMA LISA LN ARCADIA, CA 91006 | AFLAC | $147 | — | $147 | 0.76% |
| DEBORAH H HALL3 Filed as: DEBORAH H. HALL | 105 LONG LEAF PL MADISON, MS 39110 | AFLAC | $113 | — | $113 | 0.59% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 265 W. NAOMI AVE. ARCADIA, CA 91007 | AFLAC | $65 | $37 | $102 | 0.53% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 317 MARKET ST. ROCKFORD, IL 61107 | AFLAC | $92 | — | $92 | 0.48% |
| MARY M. DECKER3 | 3730 GRANTLINE RD. MIMS, FL 32754 | AFLAC | $85 | — | $85 | 0.44% |
| PAUL A SCOTT3 Filed as: PAUL A. SCOTT | 2026 N. RIVERSIDE AVENUE SUITE C 240 RIALTO, CA 92377 | AFLAC | $84 | — | $84 | 0.44% |
| BARBARA A KROLL3 Filed as: BARBARA A. KROLL | 41701 KENILWORTH LANE NOVI, MI 48377 | AFLAC | $54 | $26 | $80 | 0.41% |
| DENNY P. TWIGG3 | 24405 CHESTNUT ST. SUITE 103 SANTA CLARITA, CA 91321 | AFLAC | $77 | — | $77 | 0.40% |
| DENNY P. TWIGG3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $76 | — | $76 | 0.39% |
| DAVID HERNANDEZ3 | 3848 W. CARSON ST. SUITE 110 TORRANCE, CA 90503 | AFLAC | $73 | — | $73 | 0.38% |
| SHAWN K STEPHENS3 Filed as: SHAWN K. STEPHENS | 1323 GRAHAM TRACE LN LEAGUE CITY, TX 77573 | AFLAC | $68 | — | $68 | 0.35% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 11177 JASMINE DR. ROSCOE, IL 61073 | AFLAC | $61 | — | $61 | 0.32% |
| DAVID N MORGAN3 Filed as: DAVID N. MORGAN | 906 MERCHANT LEE PL. MANAKIN SABOT, VA 23103 | AFLAC | $45 | — | $45 | 0.23% |
| STEVEN R. JOHNSON3 | 6167 BRISTOL PKWY SUITE 106 CULVER CITY, CA 90230 | AFLAC | $39 | — | $39 | 0.20% |
| BARBARA A KROLL3 Filed as: BARBARA A. KROLL | 41701 KENILWORTH LN. NOVI, MI 48377 | AFLAC | $35 | — | $35 | 0.18% |
| LARRY W SHOWALTER3 Filed as: LARRY W. SHOWALTER | 2515 E. MARKET ST. SUITE E HARRISONBURG, VA 22801 | AFLAC | $28 | — | $28 | 0.15% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BLVD. SUITE 1225 LOS ANGELES, CA 90025 | AFLAC | $25 | — | $25 | 0.13% |
| CLAUDIA VINE3 | P.O. BOX 34174 GRANADA HILLS, CA 91394 | AFLAC | $24 | — | $24 | 0.12% |
| SHAUN M KLUG3 Filed as: SHAUN M. KLUG | 9868 HIGH MEADOW DR. YPSILANTI, MI 48198 | AFLAC | $19 | $5 | $24 | 0.12% |
| LARRY E KESSELRING3 Filed as: LARRY E. KESSELRING | 9880 E. GRAND RIVER AVE. SUITE 106 BRIGHTON, MI 48116 | AFLAC | $15 | $5 | $20 | 0.10% |
| LARRY E KESSELRING3 Filed as: LARRY E. KESSELRING | 26200 TOWN CENTER DRIVE NOVI, MI 48375 | AFLAC | $19 | — | $19 | 0.10% |
| SHERI KENNARD GAUL3 | 426 MYRTLEWOOD RD. MELBOURNE, FL 32940 | AFLAC | $16 | — | $16 | 0.08% |
| LINDA W OLGUIN3 Filed as: LINDA M. DUNFEE | 900-904 LIBERTY PLACE SICKLERVILLE, NJ 08081 | AFLAC | $15 | — | $15 | 0.08% |
| KATHLEEN A. DUFFY INSURANCE SERVICE3 Filed as: KATHLEEN A. DUFFY-LARSON | 10442 ORMOND ST. SHADOW HILLS, CA 91040 | AFLAC | $10 | $3 | $13 | 0.07% |
| MICHAEL BUTTERFIELD3 | 3120 FIRE RD. SUITE B102 EGG HARBOR TOWNSHIP, NJ 08234 | AFLAC | $12 | — | $12 | 0.06% |
| CLAUDIA VINE3 | 17729 SUPERIOR ST. UNIT 58 NORTHRIDGE, CA 91325 | AFLAC | $12 | — | $12 | 0.06% |
| MICHAEL S WITHROW3 Filed as: MICHAEL S. WITHROW | 1264 US HIGHWAY 1 SUITE 104 ROCKLEDGE, FL 32955 | AFLAC | $11 | — | $11 | 0.06% |
| MARY S. BROOKS3 | 251 PINE RIDGE DR. WAVELAND, MS 39576 | AFLAC | $10 | — | $10 | 0.05% |
| PAUL A SCOTT3 Filed as: PAUL A. SCOTT | 2026 N. RIVERSIDE AVE. SUITE C240 RIALTO, CA 92377 | AFLAC | $9 | — | $9 | 0.05% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 1840 VIA DEL REY SOUTH PASADENA, CA 91030 | AFLAC | $9 | — | $9 | 0.05% |
| LINDA DUNFEE3 Filed as: LINDA N. DUNFEE | 1241 ALMONESSON RD. DEPTFORD, NJ 08096 | AFLAC | $6 | — | $6 | 0.03% |
| DUANE A ADAMS3 Filed as: DUANE A. ADAMS | 11520 NUCKOLS RD. SUITE 103 GLEN ALLEN, VA 23059 | AFLAC | $5 | — | $5 | 0.03% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 265 W. NAOMI AVE. ARCADIA, CA 91007 | AFLAC | $4 | — | $4 | 0.02% |
| AUBRIE MICHELLE LANE3 | 13155 SHRINERS BLVD. SUITE A BILOXI, MS 39532 | AFLAC | $3 | — | $3 | 0.02% |
| AMELIA MORGAN3 Filed as: AMELIA KAY MORGAN | 1904 ELLIS DR. MAIDENS, VA 23102 | AFLAC | $3 | — | $3 | 0.02% |
| MARK D LUTHER3 Filed as: MARK D. LUTHER | 804 MOOREFIELD PARK DR. SUITE 205 NORTH CHESTERFIELD, VA 23236 | AFLAC | $3 | — | $3 | 0.02% |
| ALBERT SHUST3 | 200 CENTENNIAL AVE. SUITE 105 PISCATAWAY, NJ 08854 | AFLAC | $2 | — | $2 | 0.01% |
| MARK BUTLER INC3 Filed as: MARK BUTLER INC. | 13155 SHRINERS BLVD. SUITE A BILOXI, MS 39532 | AFLAC | $2 | — | $2 | 0.01% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DR. LOS ANGELES, CA 90045 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 12121 WILSHIRE BLVD. LOS ANGELES, CA 90025 | AFLAC | $2 | — | $2 | 0.01% |
| MARY S. BROOKS3 | 1322 SHARON ST. WAVELAND, MS 39576 | AFLAC | $1 | — | $1 | 0.01% |
| BRIAN M LEYPOLDT3 Filed as: BRIAN N. LEYPOLDT | 67 ALLISON PLACE EGG HARBOR TWP, NJ 08234 | AFLAC | $1 | — | $1 | 0.01% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN A. PITUCH | 60 US HIGHWAY 46 FAIRFIELD, NJ 07004 | AFLAC | $1 | — | $1 | 0.01% |
| TRACY BROUGHTON4 | 6 EDENDALE ST. LADERA RANCH, CA 92694 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $225 | — | $225 | 8.35% |
| SHELTER MINISTRIES, INC.4 Filed as: SHELTER MINISTRIES INC. | SUITE A244 31441 SANTA MARGARITA PKWY RANCHO SANTA MARGARITA, CA 92688 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $177 | — | $177 | 6.57% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 242 | $1.9M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 194 | $208K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 242 | $1.5M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 242 | $1.5M |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 242 | $1.5M |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 242 | $1.5M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 58 | $385K |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 242 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.