| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 660 AMERICAN AVE STE 101 KING OF PRUSSIA, PA 19406 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $4K | $872 | $5K | 11.04% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 660 AMERICAN AVE SUITE 101 KING OF PRUSSIA, PA 19406 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $203 | $203 | 0.82% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 660 AMERICAN AVE STE 101 KING OF PRUSSIA, PA 19406 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $598 | $0 | $598 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $193 | $193 | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $101 | $101 | 1.18% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 660 AMERICAN AVE SUITE 101 KING OF PRUSSIA, PA 19406 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 17.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $251 | $251 | 3.40% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENCE BLUE CROSS | 134 | $830K |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 54 | $47K |
| Vision | INDEPENDENCE BLUE CROSS | 134 | $830K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $25K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 134 | $830K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.