| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERUS INSURANCE SERVICES, LLC3 | 4170 DOUGLAS BLVD., SUITE 100 GRANITE BAY, CA 95746 | BLUE CROSS OF CALIFORNIA | $49K | — | $49K | 3.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | BLUE CROSS OF CALIFORNIA | $24K | $761 | $25K | 1.68% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.88% |
| 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 | $1K | — | $1K | 4.12% |
| ONEPOINT HUMAN CAPITAL MGMT5 | 2020 2ND STREET, SUITE 200 SELMA, CA 93662 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.99% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $966 | — | $966 | 5.88% |
| 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 | $677 | — | $677 | 4.12% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $892 | — | $892 | 5.86% |
| 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 | $630 | — | $630 | 4.14% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $808 | — | $808 | 6.05% |
| 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 | $527 | — | $527 | 3.95% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $495 | — | $495 | 6.02% |
| 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 | $328 | — | $328 | 3.99% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $201 | — | $201 | 5.84% |
| 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 | $143 | — | $143 | 4.16% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 114 | $1.5M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 29 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $33K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 114 | $1.5M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.