| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFITS ADVISORS | 4823 OLD KINGSTON PIKE SUITE 205 KNOXVILLE, TN 37919 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $3K | $34K | $37K | 5.28% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | — | $3K | $3K | 0.41% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE SUITE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $30 | $4K | 8.40% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $723 | — | $723 | 1.67% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE SUITE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $68 | $3K | 12.90% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $565 | — | $565 | 2.39% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE SUITE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $31 | $1K | 12.77% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $266 | — | $266 | 2.53% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE SUITE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $957 | $24 | $981 | 12.99% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $176 | — | $176 | 2.33% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE SUITE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $454 | $12 | $466 | 12.50% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $106 | — | $106 | 2.84% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | 162 | $693K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 90 | $43K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $4K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 34 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 21 | $8K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.