| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LES FIELDS/CCHI INSURANCE SERVICES3 | 601 MONTGOMERY STREET SUITE 315 SAN FRANCISCO, CA 94111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $10K | $10K | 1.79% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICE | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | HUMANA | $5K | $913 | $6K | 5.93% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICE | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICE | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | UNITE OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICE | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICE LLC | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 21.06% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICE | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $869 | — | $869 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INNOVATIVE BROKER SERVICE EIN 20-2970350 PLAN CONSULTANT | Consulting (general) Service code 16 | 1847 IRON POINT RD SUITE 120 FOLSOM, CA 95630 | $76K |
| BENEFIT AND RISK MANAGEMENT SERVICE EIN 68-0306908 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 80 IRON POINT RD SUITE 200 FOLSOM, CA 95630 | $46K |
| CCHI RE PLAN MANAGER | Consulting (general); Plan Administrator Service code 14 | 601 MONTGOMERY STREET SUITE 315 SAN FRANCISCO, CA 94111 | $37K |
| ROGERS BENEFIT GROUP EIN 41-1596522 PROGRAM DISTRIBUTION | Consulting (general) Service code 16 | 6540 LONETREE BLVD., SUITE 100 ROCKLIN, CA 95765 | $25K |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 169 | $571K |
| Dental(2 contracts, 2 carriers) | HUMANA | 169 | $119K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 169 | $21K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $53K |
| Long-term disability | UNITE OF OMAHA LIFE INSURANCE COMPANY | 179 | $39K |
| Prescription drug | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $549K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $549K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.