| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BELLUS INSURANCE SERVICES | PO BOX 1820 WINTER PARK, FL 32790 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $68K | $68K | 3.53% |
| FLORINE BELLUS3 | PO BOX 1820 WINTER PARK, FL 32790 | HARTFORD LIFE AND ACCIDENT | $196 | $0 | $196 | 15.02% |
| UNITED OF OMAHA LIFE INSURANCE CO Filed as: UNITED OF OMAHA LIFE INSURANCE COMP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | — |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 239 | $1.9M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 419 | $138K |
| Vision | COMPBENEFITS | 68 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $85K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $21K |
| Other | HARTFORD LIFE AND ACCIDENT | 156 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.