| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | — | HARVARD PILGRIM HEALTH CARE | $23K | — | $23K | 3.34% |
| INNOVO BENEFITS GROUP3 Filed as: INNOVO BENEFITS GROUP LLC | — | HARVARD PILGRIM HEALTH CARE | $6K | — | $6K | 0.85% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 8.08% |
| INNOVO BENEFITS GROUP3 | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.94% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | — | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 3.60% |
| INNOVO BENEFITS GROUP3 Filed as: INNOVO BENEFITS GROUP LLC | — | AMERITAS LIFE INSURANCE CORP. | $145 | — | $145 | 0.19% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 133 | $682K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 83 | $77K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 83 | $77K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $99K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $99K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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."
No prospect flags tripped on this filing.