| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE ULTIMATE SOFTWARE GROUP5 | 2000 ULTIMATE WAY WESTON, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 3.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 2.11% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 1.77% |
| THE ULTIMATE SOFTWARE GROUP5 | 2000 ULTIMATE WAY WESTON, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 3.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 2.80% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 2.18% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 9.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.74% |
| THE ULTIMATE SOFTWARE GROUP5 | 2000 ULTIMATE WAY WESTON, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.00% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 6.34% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.31% |
| THE ULTIMATE SOFTWARE GROUP5 | 2000 ULTIMATE WAY WESTON, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $4K | — | $4K | 4.72% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 3.40% |
| KEELER & ASSOCIATES3 | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $796 | — | $796 | 1.83% |
| BCINSOURCING, LLC3 Filed as: BCINSOURCING LLC | 6363 COLLEGE BOULEVARD, SUITE 500 OVERLAND PARK, KS 66211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $71 | $71 | 0.16% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 11.76% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.16% |
| THE ULTIMATE SOFTWARE GROUP5 | 2000 ULTIMATE WAY WESTON, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $888 | $888 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC. EIN 33-0441200 RX BENEFIT MANAGEMENT | Claims processing; Direct payment from the plan; Float revenue; Other fees Service code 12 | — | $2.0M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $120K |
| DELTA DENTAL OF KANSAS, INC. EIN 48-0793267 ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| OPTUM FINANCIAL, LLC ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 871095 KANSAS CITY, MO 64187 | $8K |
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 | 538 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 100 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 638 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 462 | $74K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 683 | $356K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 592 | $414K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 390 | $75K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 683 | $475K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 683 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.