| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 EAST ST STE 210 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $483 | $3K | 11.28% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS | 1 BEACON ST, STE 17100 BOSTON, MA 02108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP, STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $247 | $247 | 1.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC | 125 E ELM ST, STE 210, STE 340 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $190 | $0 | $190 | 0.83% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 EAST ST STE 210 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMAPNY | $1K | $405 | $2K | 17.84% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS | 1 BEACON ST STE 17100 BOSTON, MA 02108 | UNITED OF OMAHA LIFE INSURANCE COMAPNY | $0 | $496 | $496 | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC | 125 E ELM ST, STE 210, STE 340 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMAPNY | $124 | $0 | $124 | 1.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 EAST ST STE 210 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $329 | $2K | 17.39% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS | 1 BEACON ST STE 17100 BOSTON, MA 02108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $443 | $443 | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC | 125 E ELM ST, STE 210, STE 340 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $117 | $0 | $117 | 1.32% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 EAST ST STE 210 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $882 | $240 | $1K | 17.42% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS | 1 BEACON ST STE 17100 BOSTON, MA 02108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $322 | $322 | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC | 125 E ELM ST, STE 210, STE 340 CONSHOHOCKEN, PA 19428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $84 | $0 | $84 | 1.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $180 | $0 | $180 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN (PA) EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| THE BENECON GROUP LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $4K |
| CONNECTCARE3 LLC EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
| INNOVU BROKER | Insurance agents and brokers Service code 22 | 2403 SIDNEY ST SUITE 225 PITTSBURGH, PA 15203 | $2K |
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 | 65 | 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) | 65 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 42 | $5K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 65 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 65 | $9K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 49 | $191K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 65 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 65 | — |
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."
No prospect flags tripped on this filing.