| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY ST FARMINGTON, MO 63640 | HUMANA INSURANCE COMPANY | $29K | — | $29K | 9.82% |
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY ST FARMINGTON, MO 63640 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | — | $22K | 8.16% |
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY ST FARMINGTON, MO 63640 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15K | — | $15K | 21.14% |
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY ST FARMINGTON, MO 63640 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HCC LIFE INSURANCE COMPANY EIN 35-1817054 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 225 TOWNPARK DRIVE, SUITE 350 KENNESAW, GA 30144 | $515K |
| FIRST STATE INSURANCE AGENCY NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 204 E LIBERTY STREET FARMINGTON, MO 63640 | $219K |
| CONSOCIATE GROUP EIN 37-1351918 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | 2828 N MONROE STREET DECATUR, IL 62526 | $117K |
| HEALTH LINK NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 1831 CHESTNUT STREET ST LOUIS, MO 63103 | $52K |
| BJC WELLBEING PROGRAM EIN 75-3052953 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 4901 FOREST PARK AVENUE SUITE 1200 ST LOUIS, MO 63108 | $42K |
| D2E - DIRECT TO EMPLOYER EIN 37-1351918 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | 2828 N MONROE STREET DECATUR, IL 62526 | $32K |
| PRECEDENCE NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $15K |
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 | 696 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 696 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 414 | $296K |
| Vision | HUMANA INSURANCE COMPANY | 414 | $296K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 696 | $268K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 696 | $339K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 696 | $268K |
| Other(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 680 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 696 | — |
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.