| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | — | SIHO | $30K | — | $30K | 1.35% |
| PAYCOR INC5 Filed as: PAYCOR | PO BOX 639860 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.61% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.26% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 200 CARMEL, IN 46032 | PARAMOUNT DENTAL | $5K | $0 | $5K | 5.83% |
| CLIPPINGER FINANCIAL GROUP LLC3 | 415 CROSSLAKE DR. STE A EVANSVILLE, IN 47715 | PARAMOUNT DENTAL | $3K | $0 | $3K | 4.17% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 200 CARMEL, IN 46032 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.87% |
| CLIPPINGER FINANCIAL GROUP LLC3 Filed as: CLIPPINGER FINANCIAL GROUP, LLC | 415 CROSSLAKE DR. STE A EVANSVILLE, IN 47715 | VISION SERVICE PLAN | $745 | $0 | $745 | 4.14% |
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 | 190 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIHO | 222 | $2.2M |
| Dental | PARAMOUNT DENTAL | 284 | $84K |
| Vision | VISION SERVICE PLAN | 130 | $18K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 190 | $115K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 190 | $115K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 190 | $115K |
| Prescription drug | SIHO | 222 | $2.2M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 190 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.