| 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 | $2K | — | $2K | 1.04% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $710 | $5K | 17.61% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $867 | $3K | 20.44% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $825 | $2K | 15.70% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $636 | $3K | 19.89% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| THE LOOMIS COMPANY5 | 850 N. PARK RD. WYOMISSING, PA 19610 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MGU UNDERWRITING FEE3 | 1280 BRIGHTON WY. NEWTON SQUARE, PA 19073 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $825 | — | $825 | 7.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $486 | $2K | 20.39% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $514 | $2K | 22.06% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $707 | $294 | $1K | 21.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LOOMIS COMPANY THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | 850 N. PARK ROAD WYOMISSING, PA 19610 | $15K |
| MGU UNDERWRITING FEE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 1280 BRIGHTON WY. NEWTON SQUARE, PA 19073 | $10K |
| HILB GROUP OF WEST VIRGINIA BROKER | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 3601 MACCORKLE AVE. SE, STE. 50 CHARLESTON, WV 25304 | $10K |
| FIRST HEALTH GROUP CORPORATION CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 3200 HIGHLAND AVE. DOWNERS GROVE, IL 60515 | $2K |
| COVERDELL & COMPANY INC. BROKER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 2850 GOLF RD. ROLLING MEADOWS, IL 60008 | $416 |
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 | 184 | 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) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 75 | $233K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 59 | $27K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 27 | $13K |
| Stop-loss / reinsurancereinsurance | NATIONAL HEALTH INSURANCE COMPANY | 75 | $20K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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.