| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $175 | $0 | $175 | 5.51% |
| WATSON AND KNOX INC3 | 139 MAIN STREET PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $143 | $0 | $143 | 4.50% |
| WATSON AND KNOX INC3 | 139 MAIN ST PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $254 | $0 | $254 | 9.00% |
| WATSON AND KNOX INC3 | 139 MAIN ST PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $230 | $0 | $230 | 8.98% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $125 | $0 | $125 | 8.25% |
| WATSON AND KNOX INC3 | 139 MAIN STREET PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $102 | $0 | $102 | 6.73% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $40 | $0 | $40 | 5.43% |
| WATSON AND KNOX INC3 | 139 MAIN STREET PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33 | $0 | $33 | 4.48% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33 | $0 | $33 | 5.49% |
| WATSON AND KNOX INC3 | 139 MAIN ST PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $27 | $0 | $27 | 4.49% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $47 | $0 | $47 | 8.22% |
| WATSON AND KNOX INC3 | 139 MAIN ST PO BOX 539 THOMSON, GA 30824 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $39 | $0 | $39 | 6.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 PLAN/CLAIMS ADMINISTRATOR | Claims processing; Contract Administrator; Plan Administrator Service code 12 | — | $805 |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $3K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $736 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $3K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $2K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $3K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.