| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAMPION BENEFITS3 | AN ALERA GROUP AGENCY LLC 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | AETNA LIFE INSURANCE CO | $2K | — | $2K | 0.23% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 12.43% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.77% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $1K | $9K | 34.20% |
| AIA AMERICAN INS ADMINISTRATORS LLC5 | 4550 LENA DR MECHANICSBURG, PA 17055 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.46% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $653 | $4K | 23.79% |
| AIA AMERICAN INS ADMINISTRATORS LLC5 | 4550 LENA DR MECHANICSBURG, PA 17055 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $560 | $560 | 3.25% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $568 | $568 | 4.38% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $487 | $487 | 3.75% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $288 | $2K | 18.13% |
| AIA AMERICAN INS ADMINISTRATORS LLC5 | 4550 LENA DR MECHANICSBURG, PA 17055 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $368 | $368 | 4.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $247 | $247 | 2.69% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $809 | $373 | $1K | 14.61% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $320 | $320 | 3.96% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $253 | $2K | 23.58% |
| AIA AMERICAN INS ADMINISTRATORS LLC5 | 4550 LENA DR MECHANICSBURG, PA 17055 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $424 | $424 | 6.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $217 | $217 | 3.07% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $544 | $154 | $698 | 19.23% |
| AIA AMERICAN INS ADMINISTRATORS LLC5 | 4550 LENA DR MECHANICSBURG, PA 17055 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $218 | $218 | 6.01% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $132 | $132 | 3.64% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PKWY E STE 100 ATLANTA, GA 30346 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $519 | $114 | $633 | 18.29% |
| AIA AMERICAN INS ADMINISTRATORS LLC5 | 4550 LENA DR MECHANICSBURG, PA 17055 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $138 | $138 | 3.99% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $97 | $97 | 2.80% |
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 | 181 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO | 173 | $824K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $41K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $29K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $17K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $20K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.