| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $178K | $34K | $212K | 16.41% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $40K | $40K | 3.09% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $30K | $30K | 2.32% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $96K | — | $96K | 9.92% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | EYEMED VISION CARE | $12K | — | $12K | 9.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $802K |
| THE PLEXUS GROUPE LLC EIN 36-4116295 BROKER | Other commissions Service code 55 | — | $57K |
| HONESTRX CONSULTING LLC EIN 81-4851797 CONSULTING | Consulting fees; Consulting (general) Service code 16 | — | $0 |
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 | 1,854 | 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) | 1,854 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,811 | $963K |
| Vision | EYEMED VISION CARE | 2,235 | $127K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,854 | $1.3M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,854 | $1.3M |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,854 | $1.3M |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 1,437 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,854 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,235 | — |
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.