| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SVC AGCY INC | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.38% |
| PERFERRED BEENFITS SERVICES AGENCY3 Filed as: PERFERRED BENEFITS SVC AGCY INC | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.44% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SVC AGCY INC | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $897 | $897 | 2.39% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SVC AGCY INC | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $626 | $3K | 10.33% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.82% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SVCES AGENCY INC | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $294 | $294 | 2.48% |
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 | 495 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 501 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 929 | $278K |
| Vision | COMMUNITY INSURANCE COMPANY | 837 | $54K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 456 | $60K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 453 | $75K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $37K |
| Other(2 contracts, 2 carriers) | MATRIX INTEGRATED PSYCHOLOGICAL SERVICES AND EAP INC. | 605 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 929 | — |
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.