| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 12.31% |
| DAVID STANLEY BARNES3 Filed as: DAVID BARNES | 1036 NORTH TUSTIN AVENUE ANAHEIM, CA 92807 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $235 | $0 | $235 | 7.80% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $102 | $93 | $195 | 6.47% |
| KRISTIN ANN DECOU3 | 751 ROBIN GLEN ROAD BEAUMONT, CA 92223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $94 | $0 | $94 | 3.12% |
| TECH COORDINATOR CYBER INSURANCE SO3 Filed as: TECH COORDINATOR CYBER INSURANCE | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.80% |
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 | 386 | 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) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 386 | $74K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 386 | $74K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 386 | $77K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 386 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.