| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BLVD SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $889 | $5K | 12.14% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W SUITE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BLVD SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.59% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY SUITE 230 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| RJK & ASSOCIATES INC3 | 777 DREWRY ST NE ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $549 | $4K | 28.57% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $69 | $3K | 18.64% |
| TARA MADDOX3 | 5183 OXBOW ROAD STONE MOUNTAIN, GA 30087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 7.88% |
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BLVD SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $433 | $2K | 19.69% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W SUITE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $462 | $462 | 5.00% |
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BLVD SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $819 | $370 | $1K | 14.52% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W SUITE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $409 | $409 | 4.99% |
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BLVD SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $656 | $201 | $857 | 19.60% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W SUITE 230 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $219 | $219 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $34K |
| RSC INSURANCE BROKERAGE INC BROKER | Insurance agents and brokers Service code 22 | 1735 N BROWN ROAD SUITE 220 LAWRENCEVILLE, GA 30043 | $10K |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $42K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 59 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $4K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $41K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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.