| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 | 2839 PACES FERRY ROAD SE, SUITE 830 ATLANTA, GA 30339 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.09% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | MUTUAL OF OMAHA INSURANCE COMPANY | $6K | — | $6K | 15.27% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $1K | $1K | 3.37% |
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 | 787 | 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) | 787 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 898 | $12K |
| Vision | HM LIFE INSURANCE COMPANY | 778 | $2K |
| Life insurance | MUTUAL OF OMAHA INSURANCE COMPANY | 787 | $42K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 787 | $42K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 787 | $42K |
| Prescription drug | RXBENEFITS, INC. | 547 | $143K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 526 | $43K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 787 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 898 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.