| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY PO BOX 983 MOUNT VERNON, IL 62864 | UNITED HEALTH CARE | $5K | -$51 | $5K | 9.26% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY PO BOX 983 MOUNT VERNON, IL 62864 | MUTUAL OF OMAHA | $3K | — | $3K | 10.00% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY PO BOX 983 MOUNT VERNON, IL 62864 | MUTUAL OF OMAHA | $2K | — | $2K | 10.00% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY PO BOX 983 MOUNT VERNON, IL 62864 | MUTUAL OF OMAHA | $1K | — | $1K | 10.00% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY PO BOX 983 MOUNT VERNON, IL 62864 | MUTUAL OF OMAHA | $314 | — | $314 | 9.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | P.O. BOX 30546 SALT LAKE CITY, UT 84130 | $91K |
| UMR, INC | Claims processing Service code 12 | — | $37K |
| TEDRICK EMPLOYEE BENEFITS INC EIN 36-4178615 BROKER | Other commissions Service code 55 | 1129 BROADWAY PO BOX 983 MOUNT VERNON, IL 62864 | $37K |
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 | 115 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED HEALTH CARE | 176 | $53K |
| Vision | VSP VISION CARE | 79 | $11K |
| Life insurance(2 contracts) | MUTUAL OF OMAHA | 92 | $20K |
| Short-term disability | MUTUAL OF OMAHA | 62 | $25K |
| Long-term disability | MUTUAL OF OMAHA | 55 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.