| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $15K | $15K | 9.38% |
| EDWARD A SEIDENKRANZ3 Filed as: EDWARD SEIDENKRANZ & OTHER AGENTS | 1049 AULDRIDGE DRIVE SPRING HILL, TN 37174 | AFLAC | $83 | $0 | $83 | 3.41% |
| ALAN W FOSTER3 Filed as: ALAN W. FOSTER | 716 FRENCH RIVER ROAD NOLENSVILLE, TN 37135 | AFLAC | $56 | $0 | $56 | 2.30% |
| JORDAN S SMITH3 Filed as: JORDAN S. SMITH | 240 WILSON PIKE CIRCLE, SUITE 200 BRENTWOOD, TN 37027 | AFLAC | $55 | $0 | $55 | 2.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | AFLAC | $26 | $0 | $26 | 1.07% |
| FRED L. HOFFMAN3 Filed as: FRED HOFFMAN | 28 APPLEWOOD DRIVE FAIRFIELD, OH 45014 | AFLAC | $25 | $0 | $25 | 1.03% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AFLAC | $22 | $0 | $22 | 0.90% |
| JON R OVERACRE3 Filed as: JON R. OVERACRE | 10502 WEST 133RD TERRACE APARTMENT 107 OVERLAND PARK, KS 66213 | AFLAC | $22 | $0 | $22 | 0.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $66 | $66 | 9.14% |
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 | 327 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL CARE PLUS, INC. | 576 | $175K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 450 | $24K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 384 | $157K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 384 | $157K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 384 | $157K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 384 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 576 | — |
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.