| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 17.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 25.00% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL RD STE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 24.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JAS D COLLIER & CO AGENT FEES | Insurance brokerage commissions and fees Service code 53 | 606 S MENDENHALL ROAD STE 200 MEMPHIS, TN 38117 | $45K |
| LUCENT HEALTH SOLUTIONS ADMIN | Contract Administrator; Claims processing Service code 12 | 5560 W GRANDE MARKET DRIVE APPLETON, WI 54913 | $39K |
| MULTIPLAN REF BASEPR | Other fees Service code 99 | PO BOX 29380 NEW YORK, NY 10087 | $21K |
| MEDWATCH LLC U/R | Other fees Service code 99 | PO BOX 21796 TAMPA, FL 33630 | $15K |
| HEALTHEOS PPO CHARGE | Other fees Service code 99 | PO BOX 29380 NEW YORK, NY 10087 | $9K |
| KISX CARD LLC MED TOUR | Other fees Service code 99 | 1 KACEY COURT, STE. 100 MECHANICSBURG, PA 17055 | $8K |
| TELADOC INC. ALT CARE | Other fees Service code 99 | PO BOX 123417 DALLAS, TX 75312 | $4K |
| INTERLINK CARE MANAGEMENT INC. CC/INTER | Other fees Service code 99 | 4660 NE BELKNAP CT. 209 HILLSBORO, OR 97124 | $3K |
| FIRST CHOICE HEALTH NETWORK PPO CHARGE | Other fees Service code 99 | PO BOX 94041 SEATTLE, WA 98124 | $131 |
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 | 314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 24 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 298 | $56K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 181 | $28K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $21K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE OF COLUMBIA, SC | 299 | $203K |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.