| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 904055256 | UNITEDHEALTHCARE INSURANCE COMPANY | $42K | — | $42K | 4.54% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W. HILLSDALE BLVD. SUITE 201 SAN MATEO, CA 927056687 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 1.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | UNITEDHEALTHCARE INSURANCE COMPANY | $9K | — | $9K | 0.95% |
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 90405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.61% |
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 90405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $984 | $5K | 25.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $974 | — | $974 | 4.64% |
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 90405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $692 | $392 | $1K | 11.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $242 | — | $242 | 2.59% |
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 90405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $339 | $1K | 21.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $607 | — | $607 | 9.02% |
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 90405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $324 | $324 | 5.43% |
| JAMES P BENNETT & CO3 Filed as: JAMES P. BENNETT & CO. | 2716 OCEAN PARK BLVD. SUITE 1045 SANTA MONICA, CA 90405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $437 | $265 | $702 | 13.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $95 | — | $95 | 1.78% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 232 | $921K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 232 | $921K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 232 | $921K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 136 | $27K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 16 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 136 | $22K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 232 | $921K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 136 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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.