| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SVC AGCY INC | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $40K | $10K | $50K | 10.91% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP INC | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $8K | $18K | 3.97% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLAZA, 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 0.36% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS INC. | 225 WIRELESS BLVD #308 HAUPPAUGE, NY 11788 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 0.34% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP INC | 575 A SUNBURY ROAD DELAWARE, OH 43015 | THE GUARDIAN LIFE INSURANCE COMPANY | $745 | $166 | $911 | 24.45% |
| LIFETIME FINANCIAL GROWTH3 Filed as: LIFETIME FINANCIAL GROWTH CO | — | THE GUARDIAN LIFE INSURANCE COMPANY | $15 | — | $15 | 0.40% |
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 | 353 | 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) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 132 | $891K |
| Dental | DELTA DENTAL OF OHIO | 229 | $64K |
| Vision | VISION SERVICE PLAN | 112 | $22K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $460K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $460K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $460K |
| Prescription drug | MEDICAL MUTUAL | 132 | $891K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $463K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.