| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $28K | $52K | 9.45% |
| SAMANTHA MORRIS3 Filed as: SAMANTHA JO MORRIS | 1215 GROVE STREET ADEL, IA 50003 | CONTINENTAL AMERICAN INSURANCE COMPANY | $44K | $0 | $44K | 11.34% |
| USI INSURANCE SERVICES LLC3 | 1787 SENTRY PARKWAY WEST, VERA 16 BLUE BELL, ME 04106 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36K | $0 | $36K | 9.21% |
| LUKE J WITTROCK3 Filed as: LUKE J. WITTROCK | 136 SOUTH RINGOLD BOONE, IA 50036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26K | $0 | $26K | 6.66% |
| HEAVEN KOPF3 | 1900 CEDAR STREET, APARTMENT G SUITE 206 NORWALK, IA 50211 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11K | $0 | $11K | 2.74% |
| MONIKA M ARENDS3 Filed as: MONIKA M. ARENDS | 1912 XIRCUS AVENUE WILLIAMS, IA 50271 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | $0 | $8K | 2.07% |
| JANA L MOHS3 Filed as: JANA ADKISSON AND OTHER AGENTS | 1995 COUNTRY CLUB BOULEVARD CLIVE, IA 50325 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 1.57% |
| JANE W BARNHILL3 Filed as: JANE M. POTTEBAUM | 19258 HAWTHORN AVENUE CARROLL, IA 51401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 0.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $4K | $0 | $4K | 2.12% |
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 | 875 | 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) | 875 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 487 | $170K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 875 | $549K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 875 | $549K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 875 | $549K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 875 | $936K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 875 | — |
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.