| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORUM BENEFITS INC3 Filed as: FORUM BENEFITS, INC. | 1122 S MAIN ST STE B GREENVILLE, SC 29601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $64K | $23K | $87K | 14.78% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | — | $13K | 2.18% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 2.11% |
| MULTIPLE BROKERS (SEE APPENDIX)3 Filed as: MULTIPLE BROKERS SEE APPENDIX | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $293 | — | $293 | 13.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF SC EIN 57-0287419 MEDICAL/RX ADMIN FEES | Contract Administrator; Claims processing Service code 12 | — | $227K |
| EAP ALLIANCE EIN 57-0964632 EAP | Contract Administrator; Claims processing Service code 12 | — | $9K |
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 | 299 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $588K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $588K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $588K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $588K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $588K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $590K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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.
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.