| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | PREMERA BLUE CROSS | $298K | $82K | $380K | 4.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $51K | $14K | $65K | 18.01% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 220 EMERSON PLACE, SUITE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $431 | $431 | 0.12% |
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 | 421 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 920 | $8.3M |
| Dental | PREMERA BLUE CROSS | 920 | $8.3M |
| Vision | PREMERA BLUE CROSS | 920 | $8.3M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 431 | $360K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 431 | $360K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 431 | $360K |
| Prescription drug | PREMERA BLUE CROSS | 920 | $8.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 431 | $360K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 920 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.