| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA | $78K | — | $78K | 2.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8110 E. 32ND STREET N., SUITE 100 WICHITA, KS 67226 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 9.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | NATIONAL INCENTIVE 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | — | $15K | 8.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 12444 POWERSCOURT DRIVE, SUITE 500 ST. LOUIS, MO 63131 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 2.64% |
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 | 406 | 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) | 410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA | 257 | $2.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 261 | $229K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 261 | $229K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 406 | $173K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 406 | $173K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 406 | $173K |
| Prescription drug | BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA | 257 | $2.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 406 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.