| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HIGHMARK INC. | $28K | — | $28K | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 444 LIBERTY AVENUE, SUITE 805 PITTSBURGH, PA 15222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 14.88% |
| PAYCOR INC5 Filed as: PAYCOR, INC. | PO BOX 639860 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 444 LIBERTY AVENUE, SUITE 805 FOUR GATEWAY CENTER PITTSBURGH, PA 15222 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 5.36% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $0 | $1K | 1.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 444 LIBERTY AVENUE, SUITE 805 PITTSBURGH, PA 15222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 13.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.83% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $974 | $0 | $974 | 1.66% |
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 | 231 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. | 280 | $1.4M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 261 | $70K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 261 | $70K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 231 | $134K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 231 | $134K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 231 | $134K |
| Prescription drug | HIGHMARK INC. | 280 | $1.4M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 231 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.