| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $5K | $5K | 0.20% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN, INC. | — | $134 | $134 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.28% |
| FMLASOURCE INC5 Filed as: FMLASOURCE INC. | 455 N. CITYFRONT PLZ DR. 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 33.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.17% |
| LONG TERM CARE SOLUTIONS, INC.3 | 14715 NE 95TH ST. REDMOND, WA 98052 | LIFESECURE INSURANCE COMPANY | $1K | — | $1K | 14.22% |
| AMERICAN INDEPENDENT MARKETING3 | 511 WEST A ST. YAKIMA, WA 98902 | LIFESECURE INSURANCE COMPANY | $58 | — | $58 | 0.55% |
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 | 732 | 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) | 732 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 253 | $3.1M |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $31K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 729 | $87K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 195 | $67K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $28K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 253 | $3.1M |
| Other(6 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 729 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 729 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.