| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF CST INS AGCY | PO BOX 1070 MAGEE, MS 39111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $492 | $6K | 10.85% |
| GROUP INSURANCE SERVICES INC3 | 1607 N AURORA RD STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF CST INS AGCY | PO BOX 1070 MAGEE, MS 39111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $818 | $5K | 12.08% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.95% |
| ACCRETIVE ENROLLMENT SVCS LLC3 | 13750 SAN PEDRO AVE STE 550 SAN ANTONIO, TX 78232 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13K | — | $13K | 33.06% |
| MATTHEWS IV DAVID3 | PO BOX 2456 LAFAYETTE, LA 70502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10K | — | $10K | 26.40% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF CST INS AGCY | PO BOX 1070 MAGEE, MS 39111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $472 | $5K | 16.45% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF CST INS AGCY | PO BOX 1070 MAGEE, MS 39111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $484 | $5K | 16.76% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP, LLC | 18940 N PIMA RD SUITE 210 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $2K | $859 | $3K | 14.50% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF CST INS AGCY | PO BOX 1070 MAGEE, MS 39111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $363 | $2K | 12.05% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $900 | — | $900 | 4.95% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS GULF COAST INS. | PO BOX 2456 LAFAYETTE, LA 70502 | STERLING WELLNESS SOLUTIONS | $2K | — | $2K | 10.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF CST INS. AGCY | PO BOX 1070 MAGEE, MS 39111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $159 | $1K | 11.47% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $543 | — | $543 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $61K |
| ASSUREDPARTNERS GULF COAST INS AGCY EIN 46-4936799 BROKER | Other commissions Service code 55 | — | $16K |
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 | 549 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 571 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 22 | $33K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 373 | $58K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 343 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 549 | $79K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $33K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 366 | $18K |
| Prescription drug | TRIPLE S SALUD, INC. | 22 | $33K |
| Other(6 contracts, 5 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 549 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 549 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.