| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE DJB GROUP3 Filed as: THE DJB GROUP INC | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $236 | $1K | 6.61% |
| DMC BENEFITS INC3 | 1485 PRINCE CHARLES AVE WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $964 | $964 | 5.00% |
| HIGHSTREET INSURANCE SERVICES3 | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $301 | $0 | $301 | 1.56% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $307 | $1K | 13.16% |
| DMC BENEFITS INC3 | 1485 PRINCE CHARLES AVE WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $786 | $786 | 7.00% |
| HIGHSTREET INSURANCE SERVICES3 | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $513 | $0 | $513 | 4.57% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $685 | $134 | $819 | 14.12% |
| DMC BENEFITS INC3 | 1485 PRINCE CHARLES AVE WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $406 | $406 | 7.00% |
| HIGHSTREET INSURANCE SERVICES3 | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $185 | $0 | $185 | 3.19% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $562 | $142 | $704 | 13.10% |
| DMC BENEFITS INC3 | 1485 PRINCE CHARLES AVE WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $376 | $376 | 7.00% |
| HIGHSTREET INSURANCE SERVICES3 | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $244 | $0 | $244 | 4.54% |
| THE DJB GROUP3 Filed as: THE DJB GROUP, LLC | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $260 | $0 | $260 | 6.87% |
| HIGHSTREET INSURANCE SERVICES3 | 262 CHESTNUT ST STE 200 MEADVILLE, PA 16335 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $119 | $0 | $119 | 3.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $78K |
| HIGHSTREET INSURANCE SERVICES NORTH EIN 11-3397526 BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| HIGHMARK WEST EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | -$619 |
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 | 59 | 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) | 59 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 59 | $430K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 59 | — |
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.