| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | CALIFORNIA CHOICE | $51K | $0 | $51K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | — | CALIFORNIA CHOICE | $27K | $0 | $27K | 2.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | $2K | $0 | $2K | 8.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $603 | $603 | 5.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $493 | $493 | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 18.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $439 | $439 | 4.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $676 | $0 | $676 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $323 | $323 | 4.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | DELTA DENTAL OF CALIFORNIA | $589 | $0 | $589 | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD SUITE 1000 ROLLING MEADOW, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $896 | $0 | $896 | 23.52% |
| JAHMAAL Y BYRD4 | 731 SYMPHONY LN NW ATLANTA, GA 30318 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $23 | $0 | $23 | 0.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $229 | $0 | $229 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $107 | $107 | 4.67% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 104 | $1.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 45 | $6K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | 186 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $2K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.
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.