| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIETZ & CABALLERO INC3 | 5441 SW MACADAM AVE STE 301 PORTLAND, OR 972393823 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| DIETZ & CABALLERO INC3 | 5441 SW MACADAM AVE STE 301 PORTLAND, OR 972393823 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| DIETZ & CABALLERO INC3 | 5441 SW MACADAM AVE STE 301 PORTLAND, OR 972393823 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Other fees; Claims processing; Float revenue; Direct payment from the plan Service code 12 | 2300 MAIN STREET IRVINE, CA 92614 | $539K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | PO BOX 8077 WAUSAU, WI 544028077 | $118K |
| DIETZ & CABALLERO INC EIN 47-4957240 NONE | Other commissions Service code 55 | 5441 SW MACADAM AVE STE 301 PORTLAND, OR 97239 | $24K |
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 | 204 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $107K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.