| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.65% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.71% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $765 | $765 | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.68% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $456 | $456 | 1.50% |
| SHERMAN PTNRS LLC3 | BALDWIN KRYSTYN 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $973 | $973 | 3.44% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $424 | $424 | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $656 | $656 | 3.34% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $294 | $294 | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $396 | $396 | 3.44% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $173 | $173 | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $348 | $348 | 3.55% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $147 | $147 | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $318 | $318 | 3.51% |
| WATCHTOWER BENEFITS, LLC6 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $136 | $136 | 1.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $161 | $161 | 3.57% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $68 | $68 | 1.51% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PTNRS LLC | 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $95 | $95 | 3.58% |
| WATCHTOWER BENEFITS, LLC3 | 227 W MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $40 | $40 | 1.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 ADMINISTRATION FEES | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $80K |
| BALDWIN KRYSTYN SHERMAN PARTNERS EIN 20-4102683 BROKER | Foreign entity (e.g., an agent or broker, bank, insurance company, etc. not operating within jurisdictional boundaries of the United States) Service code 40 | 4211 W BOYSCOUT BLVD STE 800 TAMPA, FL 33607 | $75K |
| AMERICAN HEALTH DATA NETWORK EIN 35-2048379 ADMINISTRATION FEES | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $25K |
| FH GROUP CORP (FIRST HEALTH NETWORK ADMINISTRATION FEES | Contract Administrator Service code 13 | 23291 NETWORK PLACE CHICAGO, IL 60673 | $17K |
| VOLTAIRE HEALTH LLC EIN 46-2047081 ADMINISTRATION FEES | Contract Administrator Service code 13 | 5800 GRANITE PKWY SUITE 450 PLANO, TX 75024 | $4K |
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 | 359 | 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) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GREAT MIDWEST INSURANCE COMPANY | 235 | $514K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $112K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 359 | $62K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 95 | $33K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 59 | $33K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 359 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 359 | — |
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.