| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES, INC. | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91631 | CIGNA | — | $25K | $25K | 4.93% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 2.71% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO, LLC | 2040 TERRY ST LONGMONT, CO 80501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 2.64% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS, INC. | 560 S 300 E STE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 0.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS PROCESSOR | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $26K |
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 | 220 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 209 | $501K |
| Dental | CIGNA | 209 | $501K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 237 | $331K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 237 | $331K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 237 | $331K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 237 | $331K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 237 | $331K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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.