| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $430 | $13K | 10.33% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 5.00% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $597 | $11K | 13.73% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 7.18% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $943 | $7K | 8.81% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| EA LEGACY LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.40% |
| EA LEGACY LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.45% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $226 | $2K | 6.22% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $498 | $3K | 9.14% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.48% |
| EA LEGACY LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $774 | — | $774 | 2.40% |
| EA LEGACY LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 12.60% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.75% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $162 | $2K | 8.09% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $446 | $3K | 12.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.15% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 10.01% |
| EA LEGACY LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 9.45% |
| ASSUREDPARTNERS3 Filed as: HAROLD WELLS & SONS | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $911 | $152 | $1K | 6.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS, INC. EIN 35-1846036 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $116K |
| HAROLD W. WELLS & SONS, INC. EIN 56-0957752 NONE | Consulting (general); Insurance agents and brokers Service code 16 | 1 NORTH 3RD STREET WILMINGTON, NC 28401 | $74K |
| CIGNA PPO EIN 59-1031071 NONE | Other services; Claims processing Service code 12 | PO BOX 645014 CINCINNATI, OH 45264 | $24K |
| ALLYHEALTH EIN 45-1713565 NONE | Claims processing; Other services Service code 12 | — | $17K |
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 | 304 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 202 | $130K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 126 | $32K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 190 | $82K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 304 | $78K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 211 | $271K |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 303 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.