| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BKCWLP3 | PO BOX 996 KILLEEN, TX 76540 | BLUE CROSS BLUE SHIELD OF TEXAS | $50K | — | $50K | 2.73% |
| BINGHAM KLIEWER INS INC3 | 807 N 8TH STREET PO BOX 996 KILLEEN, TX 76540 | UNITED OF OMHA LIFE INSURANCE COMPANY | $23K | $0 | $23K | 15.20% |
| ADP INC5 Filed as: AUTOMATIC DATA PROCESSING INC | PO BOX 842875 BOSTON, MA 02284 | UNITED OF OMHA LIFE INSURANCE COMPANY | — | $15K | $15K | 9.45% |
| UNITED OF OMAHA LIFE INSURANCE CO5 Filed as: UNITED OF OMAHA LIFE INSURANCE | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMHA LIFE INSURANCE COMPANY | — | $6K | $6K | 3.60% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMHA LIFE INSURANCE COMPANY | — | $3K | $3K | 1.94% |
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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 424 | $1.8M |
| Dental | UNITED OF OMHA LIFE INSURANCE COMPANY | 181 | $154K |
| Vision | UNITED OF OMHA LIFE INSURANCE COMPANY | 181 | $154K |
| Life insurance | UNITED OF OMHA LIFE INSURANCE COMPANY | 181 | $154K |
| Short-term disability | UNITED OF OMHA LIFE INSURANCE COMPANY | 181 | $154K |
| Long-term disability | UNITED OF OMHA LIFE INSURANCE COMPANY | 181 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.