| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 13.95% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY & ASSOCIATES INS GROUP | 1 KELLY WAY SPARKS, MO 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $379 | $3K | 4.35% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 13.68% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY & ASSOCIATES INS GROUP | 1 KELLY WAY SPARKS, MO 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $287 | $2K | 4.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMINISTRATORS EIN 52-1358219 ADMIN | Claims processing Service code 12 | — | $73K |
| TRIBRIDGE PARTNERS, LLC BROKER | Insurance agents and brokers Service code 22 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | $55K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $26K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $9K |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $53K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $63K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 128 | $455K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.