| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE CO0 Filed as: UNITED OF OMAHA INSURANCE COMPANY | PO BOX 2147 OMAHA, NE 68103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | — |
| SMITH BOMAN & ASSOCIATES3 | 955 N STREET FRESNO, CA 93721 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | — |
| MICHAEL PAGE3 | 2866 W 13TH PL YUMA, AZ 85364 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $744 | — | $744 | — |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SOUTHWEST RISK MANAGEMENT LLC | 4801 E MCKELLIPS RD MESA, AZ 85215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $151 | — | $151 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRANSWESTER INSURANCE ADMIN CONTRACT ADMIN | Contract Administrator Service code 13 | PO BOX 9817 FRESNO, CA 93794 | $35K |
| DR PAYAN CONTRACT PROVIDER | Other fees Service code 99 | — | $33K |
| NATIONAL UNDERWRITING SERVICES STOP LOSS CARRIER | Other fees Service code 99 | 1400 N PROVIDENCE RD BDG 2 STE 4050 MEDIA, PA 19063 | $18K |
| MICHAEL PAGE BROKER | Insurance agents and brokers Service code 22 | 2866 W 13TH PL YUMA, AZ 85364 | $11K |
| SOUTHWEST RISK MANAGEMENT LLC BROKER | Insurance agents and brokers Service code 22 | 4801 E MCKELLIPS RD MESA, AZ 85215 | $2K |
| SMITH BOMAN & ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 955 N STREET FRESNO, CA 93721 | $2K |
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 | 142 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
No prospect flags tripped on this filing.