| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 1301 GRANDVIEW AVENUE, SUITE 400 PITTSBURGH, PA 15211 | HIGHMARK INC. | $62K | $0 | $62K | 3.23% |
| ASSUREDPARTNERS3 | 1301 GRANDVIEW AVENUE, SUITE 400 PITTSBURGH, PA 15211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $7K | $18K | 16.22% |
| DMC BENEFITS INC3 Filed as: DMC BENEFITS, INC. | 1485 PRINCE CHARLES AVENUE WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 7.00% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.87% |
| ASSUREDPARTNERS4 | 1301 GRANDVIEW AVENUE, SUITE 400 PITTSBURGH, PA 15211 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $434 | $0 | $434 | 8.24% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. | 324 | $1.9M |
| Dental | HIGHMARK INC. | 324 | $1.9M |
| Vision | HIGHMARK INC. | 324 | $1.9M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $111K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $111K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $111K |
| Prescription drug | HIGHMARK INC. | 324 | $1.9M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.