| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 10281 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| JEREMY BOWMAN3 Filed as: JEREMY LOYAL BOWMAN | 1110 BURKE ST FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE/ALLSTATE | $2K | — | $2K | 12.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 615 E BRITTON RD OKLAHOMA CITY, OK 73114 | AMERICAN HERITAGE LIFE/ALLSTATE | $767 | — | $767 | 5.91% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE/ALLSTATE | $183 | — | $183 | 1.41% |
| RHONDA S PAPE3 Filed as: RHONDA PAPE | 115 E PLATT ST MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE/ALLSTATE | $67 | — | $67 | 0.52% |
| ALAN PAPE3 | 115 E PLATT ST MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE/ALLSTATE | $37 | — | $37 | 0.28% |
| TRILOGY PURCHASING ALLIANCE LLC3 | 1601 S STATE ST SUITE 600 EDMOND, OK 73013 | AMERICAN HERITAGE LIFE/ALLSTATE | $17 | — | $17 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2345 GRAND BLVD SUITE 400 KANSAS CITY, MO 64108 | AMERICAN HERITAGE LIFE/ALLSTATE | $1 | — | $1 | 0.01% |
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 | 16 | 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) | 16 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE/ALLSTATE | 16 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $16K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.