| 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 | $3K | $9K | 5.32% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | MUTUAL OF OMAHA INSURANCE COMPANY | $14K | $3K | $17K | 11.92% |
| FMLASOURCE INC3 | 455 N CITYFRONT PLAZA DR 13TH FLOOR CHICAGO, IL 60611 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $15K | $15K | 10.59% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | COMPANION LIFE INSURANCE COMPANY | $9K | $1K | $11K | 11.47% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | COMPANION LIFE INSURANCE COMPANY | $12K | $1K | $13K | 16.66% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | MUTUAL OF OMAHA INSURANCE COMPANY | $708 | $135 | $843 | 11.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $408K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 NONE | Contract Administrator; Claims processing Service code 12 | — | $9K |
| 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 | 887 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 76 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 963 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 825 | $179K |
| Short-term disability(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 825 | $178K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 825 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 825 | — |
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.