| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $30K | — | $30K | 5.47% |
| MICHAEL HAND3 Filed as: MICHAEL DENNIS HAND | 355 E. RINCON STREET SUITE 105 CORONA, CA 92879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MICHAEL HAND3 Filed as: MICHAEL DENNIS HAND | 355 E. RINCON STREET SUITE 105 CORONA, CA 92879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MICHAEL HAND3 Filed as: MICHAEL DENNIS HAND | 355 E. RINCON STREET SUITE 105 CORONA, CA 92879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $149 | $2K | 10.92% |
| MICHAEL HAND3 Filed as: MICHAEL DENNIS HAND | 355 E. RINCON STREET SUITE 105 CORONA, CA 92879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $878 | — | $878 | 10.00% |
| MICHAEL HAND3 Filed as: MICHAEL DENNIS HAND | 355 E. RINCON STREET SUITE 105 CORONA, CA 92879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $684 | — | $684 | 10.00% |
| D'ANN DABELL4 | 1174 N. 2000 EAST LAYTON, UT 840402337 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $859 | — | $859 | 12.90% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON AND COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $202 | — | $202 | 3.03% |
| DON R. WILSON4 | 101 RAINBOW DRIVE PMB 4679 LIVINGSTON, TX 773991046 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $119 | — | $119 | 1.79% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 82 | $565K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 218 | $15K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $18K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 82 | $557K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.