| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP,LLC | 18700 N. HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | TOKIO MARINE HCC | — | $39K | $39K | 5.95% |
| ACRISURE LLC3 Filed as: ACRISURE , LLC | PO BOX 1417 ATMORE, AL 36504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | $6K | $25K | 13.14% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $23K | $23K | 13.80% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1417 ATMORE, AL 36504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 8.70% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1417 ATMORE, AL 36504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $5K | $21K | 19.10% |
| ACRISURE LLC3 | PO BOX 1417 ATMORE, AL 365040738 | VISON SERVICE PLAN | $12K | — | $12K | 10.79% |
| ACRISURE LLC3 | PO BOX 1417 ATMORE, AL 36504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.73% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1417 ATMORE, AL 36504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $3K | $17K | 23.39% |
| ACRISURE LLC3 | 216 TENNANT DRIVE ATMORE, AL 36502 | GUARDIAN | $7K | $208 | $7K | 14.23% |
| ACRISURE LLC3 | PO BOX 1417 ATMORE, AL 36504 | MUTUAL OF OMAHA INSURANCE COMPANY | $615 | $332 | $947 | 7.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF ALABA EIN 63-0103830 NONE | Claims processing Service code 12 | — | $502K |
| NATIONAL COOPERATIVERX EIN 04-3775178 NONE | Contract Administrator Service code 13 | — | $22K |
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 | 1,327 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 1,301 | $48K |
| Vision | VISON SERVICE PLAN | 1,326 | $110K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,386 | $276K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 518 | $192K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 289 | $91K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 1,332 | $649K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,386 | $251K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,386 | — |
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.