| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RISK STRATEGIES COMPANY3 Filed as: GOWRIE GROUP INC. | 70 ESSEX ROAD WESTBROOK, CT 06498 | DELTA DENTAL OF CT, INC. | $5K | — | $5K | 3.50% |
| ASSUREDPARTNERS0 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 11.88% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $489 | $489 | 11.81% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $414 | — | $414 | 10.00% |
| UNITED OF OMAHA LIFE INSURANCE CO5 Filed as: UNITED OF OMAHA LIFE INSURANCE | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | — |
| RISK STRATEGIES COMPANY3 Filed as: GOWRIE GROUP INC. | 70 ESSEX ROAD WESTBROOK, CT 06498 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $247 | $247 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS INC EIN 06-1475928 | Other services; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $126K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 194 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CT, INC. | 153 | $152K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $4K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $52K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS INC | 153 | $411K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.