| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CANYON RE, LLC3 | 1400 BUFORD HWY SUITE A-3 BUFORD, GA 30518 | SIRIUS AMERICA INSURANCE COMPANY | $19K | — | $19K | 3.45% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 8.00% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 15.00% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.25% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24K | — | $24K | 59.50% |
| SUPPLEMENTAL INSURANCE PROFESSIONAL3 Filed as: SUPPLEMENTAL INS PROF LLC | 1956 PARK AVENUE DES MOINES, IA 50315 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 9.90% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $235 | — | $235 | 0.59% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 7.93% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $425 | $425 | 1.25% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 26.39% |
| SUPPLEMENTAL INSURANCE PROFESSIONAL3 Filed as: SUPPLEMENTAL INS PROF LLC | 1956 PARK AVENUE DES MOINES, IA 50315 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.07% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $78 | — | $78 | 0.30% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $36 | — | $36 | 12.08% |
| TIM OLSON INC3 Filed as: TIM OLSON INC. | — | SCRIPTSOURCING | $3K | — | $3K | — |
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 | 479 | 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) | 479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 479 | $169K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 479 | $321K |
| Prescription drug | SCRIPTSOURCING | 55 | $0 |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 454 | $555K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 479 | $235K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.