| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, LLC | ATTN ACCOUNTING DEPARTMENT 8055 E TUFTS AVE, STE 1000 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $909 | $0 | $909 | 5.19% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 E UNION AVE STE 700 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $843 | $0 | $843 | 4.81% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES | ATTN ACCOUNTING DEPARTMENT 8055 E TUFTS AVE, STE 1000 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $551 | $0 | $551 | 5.18% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 E UNION AVE, STE 700 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $513 | $0 | $513 | 4.82% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 E UNION AVE, STE 700 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $391 | $0 | $391 | 5.24% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, LLC | ATTN ACCOUNTING DEPARTMENT DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $355 | $0 | $355 | 4.76% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 E UNION AVE STE 700 DENVER, CO 80237 | METROPOLITAN LIFE INSURANCE COMPANY | $601 | $43 | $644 | — |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 ATTN TELLYE HEDRICK KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $51 | $51 | — |
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 | 104 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $11K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $18K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.