| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EXCELSIOR BENEFITS LLC3 Filed as: EXCELSIOR BENEFITS LLC-OKLAHOMA | P.O. BOX 320 EXCELSIOR, MN 55331 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 0.97% |
| INSERVICES, LLC3 Filed as: INSERVICES INC. | DBA DILLINGHAM INSURANCE P.O. BOX 1669 ENID, OK 737021669 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | $3K | $18K | 12.92% |
| EXCELSIOR BENEFITS LLC3 | P.O. BOX 320 EXCELSIOR, MN 55331 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $5K | $10K | 7.34% |
| INSERVICES, LLC3 Filed as: INSERVICES, INC. | 2402 W WILLOW ROAD ENID, OK 737032324 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $2K | $12K | 19.01% |
| INSERVICES, LLC3 Filed as: INSERVICES, INC. | 2402 W WILLOW ROAD ENID, OK 737032324 | VISION SERVICE PLAN | $3K | — | $3K | 10.00% |
| INSERVICES, LLC3 Filed as: INSERVICES, INC. | 2402 W WILLOW ROAD ENID, OK 737032324 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 19.39% |
| INSERVICES, LLC3 Filed as: INSERVICES, INC. | 2402 W WILLOW ROAD ENID, OK 737032324 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $468 | $3K | 17.51% |
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 | 186 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 186 | $1.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 199 | $136K |
| Vision | VISION SERVICE PLAN | 84 | $30K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $81K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $26K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.