| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $4K | $15K | 10.19% |
| TONYA M DORMAN3 Filed as: TONYA M. DORMAN | 8569 VALLEY RANCH POINT FOUNTAIN, CO 80817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $381 | $0 | $381 | 2.56% |
| MARYJO ARNOLD3 | 4827 EXPEDITION DRIVE COLORADO SPRINGS, CO 80911 | CONTINENTAL AMERICAN INSURANCE COMPANY | $176 | $0 | $176 | 1.18% |
| BRYAN DORMAN AND OTHER AGENTS3 | 8569 VALLEY RANCH POINT FOUNTAIN, CO 80817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $105 | $0 | $105 | 0.71% |
| ZAKERY ALLEN HARLOW3 | 2960 NORTH ACADEMY BOULEVARD SUITE 100 COLORADO SPRINGS, CO 80917 | CONTINENTAL AMERICAN INSURANCE COMPANY | $103 | $0 | $103 | 0.69% |
| LAUREL LEE HARLOW3 | 6700 NORTH ORACLE ROAD TUCSON, AZ 85704 | CONTINENTAL AMERICAN INSURANCE COMPANY | $78 | $0 | $78 | 0.52% |
| THOMAS J PITZENBERGER3 Filed as: THOMAS JOSEPH PITZENBERGER | 1501 SUGARLAND PARKWAY PLEASANT HILL, MO 64080 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | $0 | $59 | 0.40% |
| KIEFER GROUP INSURANCE AGENCY LLC3 Filed as: KIEFER GROUP INSURANCE AGENCY, LLC | 12002 SOUTH MILONA DRIVE DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46 | $0 | $46 | 0.31% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $833 | $0 | $833 | 6.74% |
No Schedule C service providers reported on this filing.
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $150K |
| Vision | VISION SERVICE PLAN | 111 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $150K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $150K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $150K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.