| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 308 NORTH 21ST STREET, SUITE 100 SAINT LOUIS, MO 63103 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $30K | $30K | 4.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MISSOURI | $2K | $0 | $2K | 5.96% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 9.29% |
| BARKER PHILLIPS JACKSON INC3 Filed as: BARKER PHILLIPS JACKSON, INC. | PO BOX 4207 SPRINGFIELD, MO 65808 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $436 | $0 | $436 | 2.74% |
| USI INSURANCE SERVICES LLC3 | 308 NORTH 21ST STREET SAINT LOUIS, MO 63103 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $399 | $0 | $399 | 2.51% |
| TORREY A AMSTUTZ3 Filed as: TORREY A. AMSTUTZ | 1125 EAST LAKEWOOD SPRINGFIELD, MO 65810 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $332 | $0 | $332 | 2.09% |
| EMPLOYEE BENEFIT DESIGN LLC3 Filed as: EMPLOYEE BENEFIT DESIGN, LLC | 1125 EAST LAKEWOOD SPRINGFIELD, MO 65810 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $279 | $0 | $279 | 1.75% |
| AMY C. RUGGERI3 | 136 ARABIAN WAY SADDLEBROOKE, MO 65630 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | $0 | $20 | 0.13% |
| USI INSURANCE SERVICES LLC3 | 1715 NORTH WESTSHORE BOULEVARD SUITE 700 TAMPA, FL 33607 | ADVANTICA INSURANCE COMPANY | $951 | $0 | $951 | 10.00% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 116 | $728K |
| Dental | DELTA DENTAL OF MISSOURI | 227 | $40K |
| Vision | ADVANTICA INSURANCE COMPANY | 158 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $53K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $53K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $53K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 116 | $728K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.