| 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 | — | $1K | $1K | 1.05% |
| THE ULTIMATE SOFTWARE GROUP5 | 2000 ULTIMATE WAY WESTON, FL 33326 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 7.07% |
| SHERMAN PTNRS LLC3 | BALDWIN KRYSTYN 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.10% |
| 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 | — | $772 | $772 | 2.20% |
| SHERMAN PTNRS LLC3 | BALDWIN KRYSTYN 4211 W BOY SCOUT BLVD STE 800 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $613 | $613 | 2.02% |
| 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 | — | $414 | $414 | 2.13% |
| 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 | — | $246 | $246 | 2.10% |
| 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 | — | $249 | $249 | 2.25% |
| 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 | — | $180 | $180 | 1.99% |
| 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 | — | $110 | $110 | 2.30% |
| 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 | — | $64 | $64 | 2.27% |
| 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 | $76K |
| AMERICAN HEALTH DATA NETWORK EIN 35-2048379 ADMINISTRATION FEES | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $22K |
| FH GROUP CORP (FIRST HEALTH NETWORK ADMINISTRATION FEES | Contract Administrator Service code 13 | 23291 NETWORK PLACE CHICAGO, IL 60673 | $18K |
| 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 | 339 | 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) | 339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GREAT MIDWEST INSURANCE COMPANY | 219 | $696K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 224 | $106K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $68K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $38K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $35K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.