| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT DRIVE, SUITE 120 FOLSOM, CA 95630 | HUMANA INSURANCE COMPANY | $7K | $1K | $8K | 6.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | HUMANA INSURANCE COMPANY | $19 | — | $19 | 0.01% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $9K | $1K | $10K | 27.14% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 8.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $604 | — | $604 | 1.75% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 8.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $554 | — | $554 | 1.76% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $498 | — | $498 | 1.69% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $574 | — | $574 | 8.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $125 | — | $125 | 1.79% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNION SECURITY INSURANCE COMPANY | $482 | — | $482 | 9.98% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 40.81% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNION SECURITY INSURANCE COMPANY | $253 | — | $253 | 10.34% |
| INNOVATIVE BROKER SERVICES3 Filed as: INNOVATIVE BROKER SERVICES LLC | 1847 IRON POINT ROAD, SUITE 120 FOLSOM, CA 95630 | UNION SECURITY INSURANCE COMPANY | $326 | — | $326 | 14.91% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 146 | $128K |
| Vision | HUMANA INSURANCE COMPANY | 146 | $128K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $40K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $32K |
| Other(7 contracts, 4 carriers) | AFLAC | 157 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.