| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LORI URIAS INSURANCE SERVICES INC3 Filed as: LORI URIAS INSURANCE SERVICES | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OAMAHA LIFE INSURANCE COMPANY | $16K | — | $16K | 8.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OAMAHA LIFE INSURANCE COMPANY | — | $867 | $867 | 0.44% |
| LORI URIAS INSURANCE SERVICES INC3 Filed as: LORI URIAS INSURANCE SERVICES, INC | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | — | $10K | 20.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $508 | $508 | 1.05% |
| LORI URIAS INSURANCE SERVICES INC3 Filed as: LORI URIAS INSURANCE SERVICES, INC | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $297 | $297 | 0.97% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $248 | $248 | 0.94% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $279 | $279 | 1.08% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 20.00% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $160 | $160 | 1.07% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $313 | — | $313 | 9.99% |
| LORI URIAS INSURANCE SERVICES INC3 | PO BOX 6279 VISALIA, CA 93290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $32 | $32 | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONAL UNDERWRITING SERVICES EIN 76-0168793 STOP - LOSS CARRIER | Other fees Service code 99 | 1400 N PROVIDENCE RD BDG 2 STE 4050 MEDIA, PA 19063 | $327K |
| TRANSWESTERN INSURANCE ADMIN EIN 77-0118024 CONTRACT ADMIN | Contract Administrator Service code 13 | P.O. BOX 45019 FRESNO, CA 93718 | $57K |
| LORI URIAS INSURANCE SERVICES BROKER | Insurance agents and brokers Service code 22 | 5120 W SAN JOAQUIN DR VISALIA, CA 93277 | $42K |
| MULTIPLAN, INC EIN 13-3068979 CONTRACT PROVIDER | Other fees Service code 99 | P.O BOX 29380 NEW YORK, NY 10087 | $22K |
| PAYER COMPASS, LLC CONTRACT PROVIDER | Other fees Service code 99 | 5800 GRANITE PARKWAY STE.450 PLANO, TX 75024 | $15K |
| SMITH BOMAN & ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 955 N STREET FRESNO, CA 93721 | $9K |
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 | 217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $15K |
| Dental | UNITED OF OAMAHA LIFE INSURANCE COMPANY | 272 | $196K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 274 | $31K |
| Life insurance(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 354 | $67K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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.