| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 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 | — | $1K | $1K | 3.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 9811 KATY FWY HOUSTON, TX 77024 | UNITED CONCORDIA INSURANCE COMPANY | — | $217 | $217 | 1.13% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DR #202 ELMWOOD PARK, NJ 07407 | UNITED CONCORDIA INSURANCE COMPANY | — | $116 | $116 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $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 | — | $227 | $227 | 3.35% |
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 | 34 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 65 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 25 | $19K |
| Vision | HIGHMARK | 29 | $3K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 34 | $7K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 25 | $128K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.