| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH STREET MINNEAPOLIS, MN 55402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $436 | $3K | 17.20% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 S. 8TH STREET MINNEAPOLIS, MN 55402 | EYEMED VISION CARE | $1K | — | $1K | 9.83% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $250 | $2K | 16.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $400 | — | $400 | 5.15% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | $81 | $311 | 4.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $9 | $131 | 1.69% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $14 | $99 | 1.27% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE. #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $17 | $71 | 0.91% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE. VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.64% |
| GLYNDA C FRY-STEWART3 | 781 BRACKEN LN NIPOMO, CA 93444 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $2 | $42 | 0.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY INSURANCE BROKERS | P.O. BOX 6030 PASADENA, CA 91102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.44% |
| BART EHINGER3 | 950 CYPRESS RIDGE PKWY ARROYO GRANDE, CA 93420 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $19 | $21 | 0.27% |
| JOHN D EVANGELISTA3 | 26111 SANTA MARGARITA PKWY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.06% |
| G SCOTT COOKE3 Filed as: SCOTT ALLEN BEER | 829 CYNTHIA DRIVE WATSONVILLE, CA 95076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.03% |
| CALIFORNIA INSURANCE ADVOCATES INC3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $686 | $108 | $794 | 17.36% |
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 | 248 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $99K |
| Vision | EYEMED VISION CARE | 221 | $15K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 340 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 248 | $13K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 340 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.