| 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 | AETNA HEALTH, INC. | $63K | — | $63K | 4.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $27K | $9K | $36K | 5.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $5K | $916 | $6K | 11.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| AVANT-GARDE INSURANCE SOLUTIONS3 | 728 N. LUCIA AVENUE SUITE B REDONDO BEACH, CA 90277 | AFLAC | $347 | — | $347 | 1.29% |
| AMY EVANS3 | 4932 N. NORTH MAYWOOD AVENUE LOS ANGELES, CA 90041 | AFLAC | $297 | — | $297 | 1.11% |
| GEORGIANNA STOUT3 | 150 HARBOR DRIVE UNIT 370 SAUSALITO, CA 94966 | AFLAC | $253 | — | $253 | 0.94% |
| RENEE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $208 | — | $208 | 0.77% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL AND | INSURANCE SERVICES, INC. 28470 AVENUE STANFORD, SUITE 300 VALENCIA, CA 91355 | AFLAC | $189 | — | $189 | 0.70% |
| RICHARD J KUNZ3 Filed as: RICHARD J. KUNZ | 601 MONTGOMERY STREET SUITE 1475 SAN FRANCISCO, CA 94111 | AFLAC | $149 | — | $149 | 0.56% |
| FBRG INSURANCE SERVICES INC.3 | 733 ORCHARD LOOP AZUSA, CA 91702 | AFLAC | $137 | — | $137 | 0.51% |
| BALTOR INSURANCE SERVICES3 | 11 AIRPORT BLVD. SUITE 105 SOUTH SAN FRANCISCO, CA 94080 | AFLAC | $113 | — | $113 | 0.42% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVENUE CARLSBAD, CA 92011 | AFLAC | $95 | — | $95 | 0.35% |
| YOLANDA JOY RICHMAN3 | 10000 NEVADA AVENUE CHATSWORTH, CA 91311 | AFLAC | $92 | — | $92 | 0.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $89 | — | $89 | 0.33% |
| STEPHANIE L SANDERS3 Filed as: STEPHANIE L. SANDERS | 27305 LIVE OAK ROAD SUITE A437 SANTA CLARITA, CA 91384 | AFLAC | $88 | — | $88 | 0.33% |
| MARGARET MALLOY3 | 524 EVEN STREET NAPA, CA 94559 | AFLAC | $81 | — | $81 | 0.30% |
| ROBERT M. ABIGANA3 | 2220 CRESTMOOR DRIVE SAN BRUNO, CA 94066 | AFLAC | $69 | — | $69 | 0.26% |
| MINES INSURANCE SERVICES INC3 Filed as: MINES INSURANCE SERVICES INC. | 1519 BARTH AVENUE RICHMOND, CA 94806 | AFLAC | $68 | — | $68 | 0.25% |
| NANETTE STARK3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $66 | — | $66 | 0.25% |
| JAMES B. GARNER3 | 11 HUMBOLDT COURT PACIFICA, CA 94044 | AFLAC | $66 | — | $66 | 0.25% |
| GEOFFREY MALAIS3 | P.O. BOX 280717 NORTHRIDGE, CA 91328 | AFLAC | $55 | — | $55 | 0.20% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 14747 N. NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $47 | — | $47 | 0.18% |
| KANDI M MCINTYRE3 Filed as: KANDI M. MCINTYRE | 8429 LORRAINE ROAD SUITE 385 LAKEWOOD RANCH, FL 34202 | AFLAC | $43 | — | $43 | 0.16% |
| NOEMI OSUNA3 | 994 E. 35TH STREET LOS ANGELES, CA 90011 | AFLAC | $30 | — | $30 | 0.11% |
| MICHELLE BARBARA COSTA3 | 8117 W. 4TH STREET LOS ANGELES, CA 90048 | AFLAC | $28 | — | $28 | 0.10% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE STREET TOLUCA LAKE, CA 91602 | AFLAC | $28 | — | $28 | 0.10% |
| LILY YAN3 | 5805 SEPULVEDA BLVD. SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $27 | — | $27 | 0.10% |
| BRENDAN W DEASY3 Filed as: BRENDAN W. DEASY | P.O. BOX 278 CHINO, CA 91708 | AFLAC | $26 | — | $26 | 0.10% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $25 | — | $25 | 0.09% |
| MANA INSURANCE SOLUTIONS INC3 Filed as: MANA INSURANCE SOLUTIONS INC. | P.O. BOX 930 MAKAWAO, HI 96768 | AFLAC | $20 | — | $20 | 0.07% |
| KRISTINA J KUNZ3 Filed as: KRISTINA J. KUNZ | 118 GRANVILLE WAY SAN FRANCISCO, CA 94127 | AFLAC | $20 | — | $20 | 0.07% |
| COLLEEN ANN DAVIS3 | P.O. BOX 2823 CANYON COUNTRY, CA 91386 | AFLAC | $19 | — | $19 | 0.07% |
| DAVID SCOTT MANCHESTER3 | 11455 SW CARDIANL TERRACE BEAVERTON, OR 97008 | AFLAC | $13 | — | $13 | 0.05% |
| MJR INSURANCE SERVICES LLC3 | 5444 SEPULVEDA BLVD. APT. 106 SHERMAN OAKS, CA 91411 | AFLAC | $13 | — | $13 | 0.05% |
| CHRIS BRANSON3 | P.O. BOX 930 MAKAWAO, HI 96768 | AFLAC | $13 | — | $13 | 0.05% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $12 | — | $12 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $12 | — | $12 | 0.04% |
| BENJAMIN R. WERTHIMER3 | 6398 SAN SIMEON DRIVE ROHNERT PARK, CA 94928 | AFLAC | $10 | — | $10 | 0.04% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEIN INSURANCE SERVICES INC | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $9 | — | $9 | 0.03% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVENUE LOS ANGELES, CA 90045 | AFLAC | $9 | — | $9 | 0.03% |
| RUSSELL L WARYE3 Filed as: RUSSELL NAKAMURA | 4500 PARK GRANADA SUITE 202 CALABASAS, CA 91302 | AFLAC | $8 | — | $8 | 0.03% |
| SPALDING GROUP ENTERPRISES3 | 29404 QUAIL RUN DRIVE AGOURA HILLS, CA 91301 | AFLAC | $6 | — | $6 | 0.02% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $6 | — | $6 | 0.02% |
| TODD V MASON3 Filed as: TODD V. MASON | 1607 W. PACIFIC COAST HIGHWAY APT. 144 WILMINGTON, CA 90744 | AFLAC | $5 | — | $5 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H. WILLIS JR. | 1431 NE 55TH STREET FORT LAUDERDALE, FL 33334 | AFLAC | $4 | — | $4 | 0.01% |
| GUILLERMO H PALOMINO3 Filed as: GUILLERMO H. PALOMINO | 14224 N. 26TH DRIVE PHOENIX, AZ 85023 | AFLAC | $4 | — | $4 | 0.01% |
| ROGER M. BERMAN3 | 10610 MERIDIAN AVENUE NORTH UNIT 403A SEATTLE, WA 98133 | AFLAC | $3 | — | $3 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK STREET SUITE 615 CHICAGO, IL 60654 | AFLAC | $3 | — | $3 | 0.01% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVENUE BARRINGTON, IL 60010 | AFLAC | $3 | — | $3 | 0.01% |
| IRINA LESNYKH3 | 5112 TOPANGA CANYON BLVD. APT. 427 WOODLAND HILLS, CA 91364 | AFLAC | $3 | — | $3 | 0.01% |
| NICHOLAS E VIGIL3 Filed as: NICHOLAS E. VIGIL | 7808 E. CYPRESS STREET SCOTTSDALE, AZ 85257 | AFLAC | $2 | — | $2 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $2 | — | $2 | 0.01% |
| JULIE ATKINS3 | 16321 PACIFIC COAST HIGHWAY SPACE 6 PACIFIC PALISADES, CA 90272 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN GEORGE JAEGGI3 | 2875 NW 28TH STREET BOCA RATON, FL 33434 | AFLAC | $1 | — | $1 | 0.00% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 117 MORNING MIST LANE FRANKLIN, TN 37064 | AFLAC | $1 | — | $1 | 0.00% |
| LAUREL NICOLE HARMS3 | 785 TURRINI DRIVE DANVILLE, CA 94526 | AFLAC | $1 | — | $1 | 0.00% |
| VICTORIA L FLYNN3 Filed as: VICTORIA HOWARD | 1365 CAMINO PERAL SUITE A MORAGA, CA 94556 | AFLAC | $1 | — | $1 | 0.00% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M. MILLER | 149 MALIBU ROAD MOORESVILLE, NC 28117 | AFLAC | $1 | — | $1 | 0.00% |
| EDWARD M RYSKA3 Filed as: EDWARD M. RYSKA | 6010 ROBLAR ROAD PETALUMA, CA 94952 | AFLAC | $1 | — | $1 | 0.00% |
| JESSE RAMOS4 | 7331 SHELBY PLACE APT. 26 RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $681 | — | $681 | 7.50% |
| TANYA S. JONES4 | 1881 E. VILLA STREET PASADENA, CA 91107 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $267 | — | $267 | 2.94% |
| INTEGRITY ASSET SERVICES LLC4 | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $69 | — | $69 | 0.76% |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 328 | $2.2M |
| Dental | AETNA LIFE INSURANCE CO. | 328 | $626K |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 444 | $677K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 444 | $51K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 243 | $36K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 328 | $2.2M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 444 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 444 | — |
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."
No prospect flags tripped on this filing.