| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 3200 EAST CAMELBACK ROAD SUITE 129 PHOENIX, AZ 85018 | AETNA HEALTH OF CALIFORNIA, INC. | $32K | $0 | $32K | 3.29% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 2710 EAST CAMELBACK ROAD SUITE 210 PHOENIX, AZ 85016 | AETNA HEALTH OF CALIFORNIA, INC. | $13K | $0 | $13K | 1.27% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 3200 EAST CAMELBACK ROAD SUITE 129 PHOENIX, AZ 85018 | AETNA HEALTH OF CALIFORNIA, INC. | $0 | $4K | $4K | 0.38% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $15K | $2K | $17K | 29.56% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 18201 VON KARMAN AVE STE 510 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY (MUTUAL OF OMAHA) | $5K | $5K | $10K | 19.80% |
| JOY E GUNDERSON3 Filed as: JOY GUNDERSON | 4531 VALLECITO LN YORBA LINDA, CA 92886 | AFLAC | $2K | $29 | $2K | 5.52% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 18201 VON KARMAN AVE SUITE #510 IRVINE, CA 92612 | AFLAC | $987 | $0 | $987 | 3.11% |
| PATRICIA ANN BOSCH3 Filed as: PATRICIA BOSCH | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $788 | $29 | $817 | 2.57% |
| G COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $611 | $0 | $611 | 1.92% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $346 | $14 | $360 | 1.13% |
| CHRISTOPHER L. TANG3 Filed as: CHRISTOPHER TANG | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $126 | $0 | $126 | 0.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 E FOOTHILL BLVD PASADENA, CA 91107 | AFLAC | $123 | $0 | $123 | 0.39% |
| PAUL B KIRTON JR3 Filed as: PAUL KIRTON, JR. | 5520 WILSHIRE BLVD APT 727 LOS ANGELES, CA 90036 | AFLAC | $111 | $0 | $111 | 0.35% |
| OLIVIA COTE3 | 17417 SAN FERNANDO MISSION BLVD GRANADA HILLS, CA 91344 | AFLAC | $104 | $0 | $104 | 0.33% |
| SHARI BOYCE3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $38 | $29 | $67 | 0.21% |
| JAN C. CARROLL3 Filed as: JAN CARROLL | 502 AVENIDA ACAPULCO SAN CLEMENTE, CA 92672 | AFLAC | $51 | $0 | $51 | 0.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF CALIFORNIA INC | 500 N STATE COLLEGE BLVD. SUITE 400 ORANGE, CA 92868 | AFLAC | $51 | $0 | $51 | 0.16% |
| BARRY MCPHERSON INC3 | 2211 MICHELSON DR STE 1150 IRVINE, CA 92612 | AFLAC | $51 | $0 | $51 | 0.16% |
| STRATEGIC LIFE INSURANCE3 Filed as: STRATEGIC LIFE INS SERVICES INC. | 1936 E DEERE AVE SANTA ANA, CA 92705 | AFLAC | $33 | $0 | $33 | 0.10% |
| G SCOTT COOKE3 Filed as: SCOTT BLACKSHEAR | 3453 CATHRYN DR COLUMBUS, GA 31906 | AFLAC | $30 | $0 | $30 | 0.09% |
| DANIEL TYLER ADAMSON3 Filed as: DANIEL ADAMSON | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $17 | $0 | $17 | 0.05% |
| REBECCA ORTIZ3 | PO BOX 59044 NORWALK, CA 90652 | AFLAC | $16 | $0 | $16 | 0.05% |
| NICHOLAS RYAN DERRICO3 Filed as: NICHOLAS D'ERRICO | 1745 W ORANGEWOOD AVE STE 212 ORANGE, CA 92868 | AFLAC | $16 | $0 | $16 | 0.05% |
| ROXANNE BICKHAM3 | 10350 BASELINE RD SPC 40 RANCHO CUCAMONGA, CA 91701 | AFLAC | $13 | $0 | $13 | 0.04% |
| OWEN JOHNSTON3 | 796 N HART ST ORANGE, CA 92867 | AFLAC | $12 | $0 | $12 | 0.04% |
| DALE I DAVIS3 Filed as: DALE DAVIS | 1858 TRAVELLER RD LEXINGTON, KY 40504 | AFLAC | $12 | $0 | $12 | 0.04% |
| DAVID SMITH3 | 2220 E ROUTE 66 STE 215 GLENDORA, CA 91740 | AFLAC | $10 | $0 | $10 | 0.03% |
| CHRIS BRANSON3 | 9209 COLBERG DR AUSTIN, TX 78749 | AFLAC | $7 | $0 | $7 | 0.02% |
| RONALD I MARTINDALE3 Filed as: RONALD MARTINDALE | 2220 E ROUTE 66 STE 215 GLENDORA, CA 91740 | AFLAC | $5 | $0 | $5 | 0.02% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ | 1201 MAIN ST STE 2300 COLUMBIA, SC 29201 | AFLAC | $4 | $0 | $4 | 0.01% |
| AMANDA M GRIFFITH3 Filed as: AMANDA GRIFFITH | 11400 SE 8TH STREET #375 BELLEVUE, WA 98004 | AFLAC | $3 | $0 | $3 | 0.01% |
| TOMMY C FLEESON3 Filed as: TOMMY FLEESON | 1300 SHETTER AVE APT 1041 JACKSONVILLE BEACH, FL 32250 | AFLAC | $1 | $0 | $1 | 0.00% |
| MARK WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $1 | $0 | $1 | 0.00% |
| SHANE DAVISON3 | 120 PROVIDENCE TRL APT 1200 MT JULIET, TN 37122 | AFLAC | $1 | $0 | $1 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 3200 EAST CAMELBACK ROAD SUITE 129 PHOENIX, AZ 85018 | AETNA LIFE INSURANCE COMPANY | $773 | — | $773 | 3.07% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 2710 EAST CAMELBACK ROAD SUITE 210 PHOENIX, AZ 85016 | AETNA LIFE INSURANCE COMPANY | $410 | — | $410 | 1.63% |
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP INC | 133 FEDERAL ST FL 3 BOSTON, MA 02110 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $1K | — | $1K | 10.09% |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 2 | $25K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 194 | $57K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 162 | $12K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (MUTUAL OF OMAHA) | 151 | $75K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (MUTUAL OF OMAHA) | 151 | $75K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (MUTUAL OF OMAHA) | 151 | $75K |
| Prescription drug | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 194 | $57K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (MUTUAL OF OMAHA) | 151 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.