| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 18201 VON KARMAN AVE SUITE 510 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.85% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.84% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.93% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.83% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $523 | $122 | $645 | 7.68% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $353 | $45 | $398 | 4.74% |
| GENA LYNNE MOORE3 | 3717 ASHFORK LANE BAKERSFIELD, CA 93309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $330 | $28 | $358 | 4.26% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $286 | $14 | $300 | 3.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2560 PROFESSIONAL PARKWAY SANTA MARIA, CA 93455 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 2.75% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | $4 | $229 | 2.73% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $159 | $2 | $161 | 1.92% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.51% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE. VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.44% |
| GLYNDA C FRY-STEWART3 | 12060 84TH STREET LEXINGTON, OK 73051 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.15% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK RD PLANT CITY, FL 33567 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.06% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.04% |
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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 336 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 192 | $127K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 337 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 331 | $52K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 331 | $22K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 331 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 337 | — |
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.