| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| H&H INSURANCE LLC3 | 4203 PINE COVE RD. BILLINGS, MT 59106 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| H&H INSURANCE LLC3 | 1629 AVENUE D SUITE B6 BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $919 | — | $919 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DWS HOLDINGS DBA PINNACLE PEAK ADM. EIN 45-3763152 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $83K |
| COASTAL ADMINISTRATIVE BENEFITS EIN 91-1991574 3RD-PARTY ADMIN, CLAIMS | Claims processing Service code 12 | — | $34K |
| NSQUARED EIN 84-4233260 PRODUCER | Insurance agents and brokers Service code 22 | — | $23K |
| H&H INSURANCE EIN 92-2801001 PRODUCER FEES | Insurance agents and brokers Service code 22 | — | $11K |
| HAWAII MAINLAND ADMINISTRATORS PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 1600 W. BROADWAY RD. #300 TEMPE, AZ 85282 | $7K |
| AMERITAS PLAN ADMINISTRATOR | Plan Administrator Service code 14 | PO BOX 81889 LINCOLN, NE 68501 | $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 | 131 | 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) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $14K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.