| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33K | $9K | $42K | 14.59% |
| FMLA SOURCE INC5 | 455 N CITY FRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 2.56% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 1.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MANAGER | Other fees; Direct payment from the plan; Claims processing; Float revenue Service code 12 | 6300 OLSON MEMORIAL HIGHWAY GOLDEN VALLEY, MN 55427 | $1.4M |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 7440 WOODLAND DRIVE INDIANAPOLIS, IN 46278 | $117K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 225 S EAST STREET INDIANAPOLIS, IN 46202 | $18K |
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 | 506 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 512 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 506 | $287K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 506 | $287K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 506 | $287K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 506 | $287K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 506 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.