| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP CENTRAL LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 8.15% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP CENTRAL LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $6K | 19.80% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP CENTRAL, LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 20.16% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP CENTRAL, LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $969 | $4K | 19.80% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP CENTRAL LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $293 | $2K | 17.73% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP CENTRAL LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $439 | $2K | 19.33% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP CENTRAL LLC | 3000 WESLAYAN ST., STE. 390 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $407 | $2K | 19.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HILB GROUP - CLARUS & CO. EIN 83-4076772 BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $40K |
| HILB GROUP - CLARK & LAVEY EIN 47-4324398 BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $37K |
| ULTRABENEFITS INC. EIN 04-3525752 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $37K |
| CIGNA EIN 59-1031071 TPA | Contract Administrator; Claims processing Service code 12 | — | $22K |
| RIGHTWAY EIN 82-0865206 CONCIERGE | Claims processing Service code 12 | — | $7K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 CASE MANAGEMENT | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $3K |
| TELEDOC EIN 20-1020949 TELEMEDICINE | Claims processing; Contract Administrator; Other services Service code 12 | — | $2K |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 106 | $68K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 106 | $68K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 62 | $20K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 43 | $28K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.