| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 0.46% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | WILLAMETTE DENTAL INSURANCE INC | $5K | — | $5K | 5.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 12.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $443 | $3K | 12.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BERKLEY LIFE & HEALTH EIN 91-6034263 NONE | Insurance services Service code 23 | — | $596K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 NONE | Contract Administrator Service code 13 | — | $147K |
| CU BENEFITS ALLIANCE EIN 61-1691027 NONE | Insurance agents and brokers Service code 22 | — | $85K |
| THE GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 CLAIMS PROCESSOR | Contract Administrator Service code 13 | — | $11K |
| UNITED OF OMAHA LIFE INSURANCE CO EIN 47-0322111 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL INSURANCE INC | 205 | $109K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 222 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $56K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $403K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.