| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: SAMM E TAGUE MUTUAL OF OMAHA | 4700 S LINDBERGH BOULEVARD SAINT LOUIS, MO 63126 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.36% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $261 | — | $261 | 0.86% |
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: SAMM E TAGUE MUTUAL OF OMAHA | 4700 S LINDBERGH BOULEVARD SAINT LOUIS, MO 63126 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 12.10% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $440 | — | $440 | 2.90% |
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: SAMM E TAGUE MUTUAL OF OMAHA | 4700 S LINDBERGH BOULEVARD SAINT LOUIS, MO 63126 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $799 | — | $799 | 8.17% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $178 | — | $178 | 1.82% |
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: SAMM E TAGUE MUTUAL OF OMAHA | 4700 S LINDBERGH BOULEVARD SAINT LOUIS, MO 63126 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $383 | — | $383 | 8.26% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $80 | — | $80 | 1.73% |
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: SAMM E TAGUE MUTAL OF OMAHA | 4700 S LINDBERGH BOULEVARD SAINT LOUIS, MO 63126 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $218 | — | $218 | 8.26% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $46 | — | $46 | 1.74% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $30K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $18K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 29 | $14K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.