| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $78K | $78K | 3.31% |
| IMA, INC.3 | 1550 17TH ST. SUITE 600 DENVER, CO 80202 | CALIFORNIA PHYSICIANS' SERVICE | — | $45K | $45K | 1.89% |
| IMA, INC.3 | 1550 17TH ST. SUITE 600 DENVER, CO 80202 | CALIFORNIA PHYSICIANS' SERVICE | — | $2K | $2K | 0.08% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $96K | — | $96K | 5.31% |
| IMA, INC.3 | P.O. BOX 102833 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $15K | — | $15K | 7.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $5K | — | $5K | 2.43% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $5K | $16K | 20.73% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $5K | $16K | 20.72% |
| FMLASOURCE INC5 Filed as: FMLASOURCE INC. | 455 N. CITYFRONT PLZ DR. 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 8.39% |
| MYKISHA L. THOMAS3 Filed as: MYKISHA L. BUTLER | 3886 3RD AVE. LOS ANGELES, CA 90008 | AFLAC | $2K | $112 | $2K | 9.65% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $1K | — | $1K | 4.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AFLAC | $651 | — | $651 | 2.79% |
| ISAAC SANDOVAL3 | 3959 W. 182ND ST. APT. 238 TORRANCE, CA 90504 | AFLAC | $509 | $12 | $521 | 2.23% |
| DAVID HERNANDEZ3 | 2239 W. 190TH ST. TORRANCE, CA 90504 | AFLAC | $480 | $35 | $515 | 2.20% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DR. FRISCO, TX 75033 | AFLAC | $116 | — | $116 | 0.50% |
| ANA FRANCIS CORDOVA3 | 23701 S. WESTERN AVE. SPC 124 TORRANCE, CA 90501 | AFLAC | $87 | $23 | $110 | 0.47% |
| BRANDON TYLOR-DA SHIRLEY3 | 5110 S. SHERBOURNE DR. LOS ANGELES, CA 90056 | AFLAC | $40 | — | $40 | 0.17% |
| HUY DUC NGUYEN3 | 1915 W. 182ND ST. TORRANCE, CA 90504 | AFLAC | $10 | $3 | $13 | 0.06% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.99% |
| PATRICIA SWANSON4 | 579 W. LEMON AVE. MONROVIA, CA 91016 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $119 | — | $119 | 9.97% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $31 | — | $31 | 2.60% |
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 | 381 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 211 | $4.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 292 | $200K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 292 | $200K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 380 | $98K |
| Short-term disability | AFLAC | 20 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 380 | $79K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 211 | $4.2M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 380 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.