| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SWARTZBAUGH-FARBER & ASSOCIATES INC3 Filed as: SWARTZBAUGH-FARBER & ASSOCIATES | 9140 W DODGE RD STE 418 OMAHA, NE 68114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.54% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| SWARTZBAUGH-FARBER & ASSOCIATES INC3 Filed as: SWARTZBAUGH-FARBER & ASSOCIATES | 9140 W DODGE RD STE 418 OMAHA, NE 68114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 11.26% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| SWARTZBAUGH-FARBER & ASSOCIATES INC3 Filed as: SWARTZBAUGH-FARBER & ASSOCIATES | 9140 W DODGE RD STE 418 OMAHA, NE 68114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.50% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $2K | $4K | 24.47% |
| SWARTZBAUGH-FARBER & ASSOCIATES INC3 Filed as: SWARTZBAUGH-FARBER & ASSOCIATES | 9140 W DODGE RD STE 418 OMAHA, NE 68114 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $33 | $3K | 17.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 ADMIN | Claims processing Service code 12 | — | $45K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $23K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $7K |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 98 | $16K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 98 | $16K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $23K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $34K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $32K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 118 | $359K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.