| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC - MN | LOCKBOX 749140 COLLEGE PARK, GA 30349 | DELTA DENTAL OF MISSOURI | $1K | $251 | $2K | 4.88% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 5608 WALNUT CREEK, CA 94596 | DELTA DENTAL OF MISSOURI | $270 | $0 | $270 | 0.79% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $872 | $0 | $872 | 6.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 1200 MAIN ST STE 2310 KANSAS CITY, MO 64105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $214 | $392 | $606 | 4.68% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE STE 100 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $208 | $0 | $208 | 1.61% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $812 | $0 | $812 | 6.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 1200 MAIN ST STE 2310 KANSAS CITY, MO 64105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $195 | $372 | $567 | 4.75% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE STE 100 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $187 | $0 | $187 | 1.57% |
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 | 135 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MISSOURI | 135 | $34K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $25K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.