| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-STD | — | $5K | $5K | 10.07% |
| NATIONAL WORKSITE BENEFIT GROUP3 | 6 E CHESTNUT ST STE 520 AUGUSTA, ME 043305759 | UNITED OF OMAHA LIFE INSURANCE COMPANY-STD | $5K | — | $5K | 10.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-STD | — | — | $0 | 0.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LTD | — | $4K | $4K | 10.45% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | 6 E CHESTNUT STREET STE 520 AUGUSTA, ME 043305759 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LTD | $4K | — | $4K | 10.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LTD | — | — | $0 | 0.00% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | 6 E CHESTNUT ST STE 520 AUGUSTA, ME 043305759 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD-V | $5K | — | $5K | 14.90% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD-V | — | $3K | $3K | 11.22% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD-V | — | — | $0 | 0.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD | — | $3K | $3K | 10.49% |
| NATIONAL WORKSITE BENEFIT GROUP3 | 6 E CHESTNUT ST STE 520 AUGUSTA, ME 043305759 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD | $3K | — | $3K | 10.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 033017427 | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD | — | — | $0 | 0.00% |
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 | 165 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD | 165 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY-STD | 165 | $53K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY-LTD | 165 | $41K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY-LIFEADD-V | 396 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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."
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.