| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | MUTUAL OF OMAHA INSURANCE COMPANY | $6K | — | $6K | 3.38% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | MUTUAL OF OMAHA INSURANCE COMPANY | $14K | — | $14K | 10.00% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLAZA DRIVE CHICAGO, IL 60611 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $12K | $12K | 8.27% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | COMPANION LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | COMPANION LIFE INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | MUTUAL OF OMAHA INSURANCE COMPANY | $698 | — | $698 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $458K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 NONE | Contract Administrator; Claims processing Service code 12 | — | $10K |
| NATIONAL VISION ADMINISTRATORS LLC EIN 74-3033381 NONE | Contract Administrator Service code 13 | — | $6K |
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 | 855 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 64 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 937 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 822 | $145K |
| Short-term disability(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 824 | $185K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 822 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 824 | — |
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.