| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 Filed as: UMR INC | — | QBE INSURANCE CORPORATION | $77K | — | $77K | 75.79% |
| ART HAUSER INSURANCE INC3 Filed as: ART HAUSER INSURANCE | 5905 E GALBRAITH RD SUITE 9000 CINCINNATI, OH 45236 | QBE INSURANCE CORPORATION | $27K | — | $27K | 26.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | PO BOX 30541 SALT LAKE CITY, UT 84130 | $79K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 30541 SALT LAKE CITY, UT 84130 | $77K |
| ART HAUSER INSURANCE INC EIN 31-0800707 BROKER | Other commissions Service code 55 | 5905 E GALBRAITH ROAD STE 9000 CINCINNATI, OH 45236 | $27K |
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 | 105 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QBE INSURANCE CORPORATION | 15 | $102K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 15 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.