| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE CO0 Filed as: MUTUAL OF OMAHA COMPANIES | PO BOX 2147 OMAHA, NE 681032147 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | — |
| SMITH BOMAN & ASSOCIATES3 | 955 N STREET FRESNO, CA 93721 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $449 | $0 | $449 | — |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SOUTHWEST RISK MANAGEMENT, LLC | 4801 E MCKELLIPS RD MESA, AZ 85215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $299 | $0 | $299 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONAL UNDERWRITING SERVICES STOP LOSS CARRIER | Other fees Service code 99 | 1400 N PROVIDENCE RD BDG 2 STE 4050 MEDIA, PA 19063 | $88K |
| TRANSWESTERN INSURANCE ADMIN CONTRACT ADMIN | Contract Administrator Service code 13 | PO BOX 9817 FRESNO, CA 93794 | $23K |
| SOUTHWEST RISK MANAGEMENT, LLC BROKER | Insurance agents and brokers Service code 22 | 4801 E MCKELLIPS RD MESA, AZ 85215 | $18K |
| SMITH BOMAN & ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 955 N STREET FRESNO, CA 93721 | $3K |
| MULTIPLAN, INC PROVIDER CONTRACT | Other fees Service code 99 | PO BOX 29380 NEW YORK, NY 100879380 | $830 |
| PAYER COMPASS, LLC PROVIDER CONTRACT | Other fees Service code 99 | 5800 GRANITE PARKWAY STE 450 PLANO, TX 75024 | $530 |
| 24/7 CALL-A-DOC, LLC PROVIDER CONTRACT | Other fees Service code 99 | 900 N FEDERAL HWY STE 306 HALLANDALE, FL 33009 | $314 |
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 | 101 | 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) | 101 | 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.