| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 12444 POWERSCOURT DRIVE SUITE 500 ST. LOUIS, MO 63131 | BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA | $35K | — | $35K | 2.51% |
| 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 | $14K | — | $14K | 11.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 4.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | GALLAGHER BENEFIT SERVICES INC.CHIC PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $352 | — | $352 | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 12444 POWERSCOURT DRIVE SUITE 500 SAINT LOUIS, MO 63131 | GUARDIAN | $10K | $3K | $13K | 12.60% |
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 | 99 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA | 0 | $1.4M |
| Dental | GUARDIAN | 138 | $106K |
| Vision | GUARDIAN | 138 | $106K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $128K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $128K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $128K |
| Prescription drug | BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA | 0 | $1.4M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.