| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $93 | $3K | 1.79% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $40 | $4K | 15.16% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $21 | $4K | 15.08% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $45 | $4K | 15.18% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| THE LOOMIS COMPANY3 | 850 N. PARK ROAD WYOMISSING, PA 19610 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MGU UNDERWRITING FEE5 | 1280 BRIGHTON WAY NEWTON SQUARE, PA 19073 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 7.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $15 | $2K | 15.14% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $47 | $1K | 10.46% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $27 | $1K | 15.33% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $7 | $1K | 15.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LOOMIS COMPANY BROKER | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 850 N. PARK ROAD WYOMISSING, PA 19610 | $12K |
| HILB GROUP OF WEST VIRGINIA BROKER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 3601 MACCORKLE AVE., SE CHARLESTON, WV 25304 | $9K |
| MGU UNDERWRITING FEE TPA | Claims processing Service code 12 | 1280 BRIGHTON WAY NEWTON SQUARE, PA 19073 | $7K |
| FIRST HEALTH GROUP CORPORATION CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 3200 HIGHLAND AVE. DOWNERS GROVE, IL 60515 | $4K |
| COVERDELL & COMPANY INC. BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 2850 GOLF RD. ROLLING MEADOWS, IL 60008 | $455 |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 53 | $196K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $25K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 209 | $36K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 43 | $25K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 53 | $20K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 209 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.