| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 8144 WALNUT HILL LANE 16TH FL DALLAS, TX 75231 | HARTFORD LIFE & ACCIDENT | $0 | $4K | $4K | 2.74% |
| MARSH & MCLENNAN AGENCY LLC3 | 100 FRONT ST STE 800 WORCHESTER, MA 01608 | HARTFORD LIFE & ACCIDENT | $0 | $3K | $3K | 1.65% |
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: MUTUAL OF OMAHA | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP AND PENSION ADMIN. INC. | Claims processing Service code 12 | PARK CENTRAL 8 12770 MERIT DRIVE, SUITE 200 DALLAS, TX 75251 | $117K |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 537 | $22K |
| Life insurance | HARTFORD LIFE & ACCIDENT | 224 | $153K |
| Short-term disability | HARTFORD LIFE & ACCIDENT | 224 | $153K |
| Stop-loss / reinsurancereinsurance | RELIANCE STANDARD LIFE | 242 | $756K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE & ACCIDENT | 224 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 537 | — |
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.