| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONAL CARE INC5 Filed as: REGIONAL CARE INC. | 905 W 27TH STREET SCOTTSBLUFF, NE 69361 | AIG BENEFIT SOLUTIONS | $3K | — | $3K | 10.00% |
| GEORGE B BRYCE3 | 747 W 1ST ST. CASPER, WY 82601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $365 | — | $365 | 4.69% |
| KELLI J CARMICHAEL3 | 747 W 1ST ST CASPER, WY 82601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $365 | — | $365 | 4.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGIONAL CARE, INC. EIN 47-0760050 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $42K |
| EDWARD T. HAGER, CPA, LLC NONE | Other fees; Accounting (including auditing); Direct payment from the plan Service code 10 | 555 S WOLCOTT STREET CASPER, WY 82601 | $33K |
| NEEDLES & ASSOCIATES, LLC EIN 51-0435869 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $15K |
| FIRST CHOICE OF THE MIDWEST EIN 91-1832429 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $10K |
| KELLI CARMICHAEL EIN 52-0765556 NONE | Insurance agents and brokers Service code 22 | — | $9K |
| SPENCER FANE LLP EIN 44-0561981 NONE | Legal; Direct payment from the plan Service code 29 | — | $5K |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 199 | $8K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY | 180 | $525K |
| Other(2 contracts, 2 carriers) | AIG BENEFIT SOLUTIONS | 199 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.