| 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 | BLUE CROSS OF CALIFORNIA | $227K | $35K | $262K | 5.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | $834 | $28K | 5.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $136 | $5K | 4.89% |
| BRIAN YERVANT AKIAN3 | P.O. BOX 17269 IRVINE, CA 92623 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $124 | $2K | 14.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $731 | — | $731 | 5.32% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 9301 NW 33RD STREET DORAL, FL 33172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $285 | $84 | $369 | 2.68% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $357 | — | $357 | 2.60% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $30 | $95 | 0.69% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | GERBER LIFE INSURANCE COMPANY | $412 | — | $412 | 15.01% |
| PHYLLIS JOY4 | SELZNICK BLITZ 21115 KNIGHTS GLN LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $79 | — | $79 | 12.31% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $34 | — | $34 | 5.30% |
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 | 330 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 338 | $5.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 338 | $4.4M |
| Vision(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 338 | $5.0M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 338 | $4.4M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 338 | $4.4M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 338 | $4.4M |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 338 | $5.0M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 338 | $4.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.