| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY | P.O. BOX 1779 BOWLING GREEN, KY 42101 | HUMANA INSURANCE COMPANY | $27K | — | $27K | 5.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | P.O. BOX 9465 NEW YORK, NY 10087 | HUMANA INSURANCE COMPANY | $25K | $614 | $25K | 4.84% |
| INSURANCE SPECIALITS LLC3 | 1750 SCOTTSVILLE ROAD BOWLING GREEN, KY 42104 | HUMANA INSURANCE COMPANY | — | $2K | $2K | 0.39% |
| TRACY L HOSTLER3 Filed as: TRACY HINRICHS | 7182 LIBERTY CENTRE DRIVE WEST CHESTER, OH 45069 | HUMANA INSURANCE COMPANY | $2K | $37 | $2K | 0.38% |
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY | P.O. BOX 1779 BOWLING GREEN, KY 42102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $5K | $12K | 14.80% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | 1166 6TH AVENUE NEW YORK, NY 10036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 11.03% |
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY | P.O. BOX 1779 BOWLING GREEN, KY 42102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 14.11% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | 1166 6TH AVENUE NEW YORK, NY 10036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 11.57% |
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY | P.O. BOX 1779 BOWLING GREEN, KY 42102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 13.47% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | 1166 6TH AVENUE NEW YORK, NY 10036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 11.52% |
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY | P.O. BOX 1779 BOWLING GREEN, KY 42102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $770 | $2K | 13.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | 1166 6TH AVENUE NEW YORK, NY 10036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.55% |
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 | 252 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 263 | $521K |
| Dental | HUMANA INSURANCE COMPANY | 263 | $521K |
| Vision | HUMANA INSURANCE COMPANY | 263 | $521K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 271 | $111K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 208 | $0 |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $50K |
| Stop-loss / reinsurancereinsurance | HUMANA INSURANCE COMPANY | 263 | $521K |
| Other(3 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 271 | $631K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 271 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.