| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | CALIFORNIA CHOICE | $37K | — | $37K | 4.17% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | — | CALIFORNIA CHOICE | $14K | — | $14K | 1.54% |
| BINNEY CHASE AND VAN HORNE3 Filed as: BINNEY CHASE & VAN HORNE | — | CALIFORNIA CHOICE | $7K | — | $7K | 0.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 6.65% |
| NEWSOM, BRUCE C.3 | 505 N. BRAND BLVD. SUITE 200 GLENDALE, CA 91203 | HUMANA INSURANCE COMPANY | $585 | — | $585 | 1.75% |
| STEPHANIE L SANDERS3 Filed as: STEPHANIE L. SANDERS | 27305 LIVE OAK RD. A437 SANTA CLARITA, CA 91384 | AFLAC | $1K | $141 | $2K | 7.40% |
| MICHELLE C. LEE3 | 1044 LOMA LISA LN. ARCADIA, CA 91006 | AFLAC | $663 | $28 | $691 | 3.39% |
| BINNEY CHASE AND VAN HORNE3 Filed as: BINNEY CHASE & VAN HORNE INC. | 505 N. BRAND BLVD. SUITE 600 GLENDALE, CA 91203 | AFLAC | $384 | — | $384 | 1.88% |
| MICHAEL R. FISHER3 | 50 W. LEMON AVE. SUITE 2 MONROVIA, CA 91016 | AFLAC | $298 | $28 | $326 | 1.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $252 | — | $252 | 1.24% |
| LINDA R NIKKHOO3 Filed as: LINDA R. NIKKHOO | 24307 MAGIC MOUNTAIN PKWY. SUITE 627 VALENCIA, CA 91355 | AFLAC | $103 | — | $103 | 0.51% |
| VALERIE T. VAN HORN3 | 3223 S. BERNARD ST. SPOKANE, WA 99203 | AFLAC | $103 | — | $103 | 0.51% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVE. CARLSBAD, CA 92011 | AFLAC | $91 | — | $91 | 0.45% |
| DENNY P. TWIGG3 | 24405 CHESTNUT ST. SUITE 103 SANTA CLARITA, CA 91321 | AFLAC | $72 | — | $72 | 0.35% |
| RENE CASTRO3 | 5460 E. EL PARQUE ST. LONG BEACH, CA 90815 | AFLAC | $62 | — | $62 | 0.30% |
| ARROYO INSURANCE SERVICES, INC.3 Filed as: ARROYO INSURANCE SERVICES INC. | 13749 RIVERSIDE DR. SUITE 204 SHERMAN OAKS, CA 91423 | AFLAC | $60 | — | $60 | 0.29% |
| KATHY DUFFY INSURANCE SERVICES3 | 10442 ORMOND ST. SHADOW HILLS, CA 91040 | AFLAC | $55 | — | $55 | 0.27% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PL. UNIT 18C NEW YORK, NY 10017 | AFLAC | $44 | — | $44 | 0.22% |
| GAYK TONY DZHORDZHALYAN3 | 701 HAY ST. MONTEBELLO, CA 90640 | AFLAC | $43 | — | $43 | 0.21% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 701 ALBEROSKY WAY BATAVIA, IL 60510 | AFLAC | $40 | — | $40 | 0.20% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $36 | — | $36 | 0.18% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST. SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $36 | — | $36 | 0.18% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LN. LOS ANGELES, CA 90049 | AFLAC | $30 | — | $30 | 0.15% |
| ALEX L. PEREZ3 | 4169 MONTEREY AVE. BALDWIN PARK, CA 91706 | AFLAC | $19 | — | $19 | 0.09% |
| DENNY P. TWIGG3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $15 | — | $15 | 0.07% |
| MARSHALL CHARLES MCDONALD3 | 415 DAVIDSON GATEWAY DR. APT. 7 DAVIDSON, NC 28036 | AFLAC | $13 | — | $13 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N. BRAND BLVD. SUITE 600 GLENDALE, CA 91203 | AFLAC | $13 | — | $13 | 0.06% |
| MARIAN A LOPEZ3 Filed as: MARIAN A. LOPEZ | 13322 CITICOURT LN. WHITTIER, CA 90602 | AFLAC | $11 | — | $11 | 0.05% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE. LOS ANGELES, CA 90045 | AFLAC | $7 | — | $7 | 0.03% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 377 E. BUTTERFIELD RD. SUITE 210 LOMBARD, IL 60148 | AFLAC | $5 | — | $5 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H. WILLIS JR. | 1431 NE 55TH ST. FORT LAUDERDALE, FL 33334 | AFLAC | $3 | — | $3 | 0.01% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BLVD. SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $3 | — | $3 | 0.01% |
| JUANITA BURKS & ASSOCIATES3 | 6100 CENTER DR., SUITE 670 LOS ANGELES, CA 90045 | AFLAC | $3 | — | $3 | 0.01% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 117 MORNING MIST LN. FRANKLIN, TN 37064 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK ST. SUITE 625 CHICAGO, IL 60654 | AFLAC | $2 | — | $2 | 0.01% |
| TIANI C. WARREN3 | 5700 COLISEUM ST. LOS ANGELES, CA 90016 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR. LOS ANGELES, CA 90039 | AFLAC | $1 | — | $1 | 0.00% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVE. BARRINGTON, IL 60010 | AFLAC | $1 | — | $1 | 0.00% |
| JESSICA PEREZ3 | 11835 W. OLYMPIC BLVD. SUITE 795E LOS ANGELES, CA 90064 | AFLAC | $1 | — | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR. WALNUT CREEK, CA 94598 | AFLAC | $1 | — | $1 | 0.00% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE ST. TOLUCA LAKE, CA 91602 | AFLAC | $1 | — | $1 | 0.00% |
| JOSHUA SASCHA T. SCHNEELOCH3 | 8549 WILSHIRE BLVD. SUITE 1084 BEVERLY HILLS, CA 90211 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | HUMANA DENTAL INSURANCE COMPANY | $1K | — | $1K | 5.98% |
| NEWSOM, BRUCE C.3 | 505 N. BRAND BLVD. SUITE 200 GLENDALE, CA 91203 | HUMANA DENTAL INSURANCE COMPANY | $239 | — | $239 | 1.36% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 138 | $887K |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 107 | $51K |
| Vision | HUMANA INSURANCE COMPANY | 107 | $33K |
| Life insurance | AFLAC | 26 | $20K |
| Short-term disability | AFLAC | 26 | $20K |
| Other | AFLAC | 26 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.