| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 555 S PERRYVILLE ROAD ROCKFORD, IL 61108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $35K | — | $35K | 15.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOW, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 3.09% |
| FMLASOURCE INC3 | 455 N CITYFRONT PLZ DR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 555 S PERRYVILLE ROAD ROCKFORD, IL 61125 | DEARBORN NATIONAL | $20K | — | $20K | 25.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 555 S PERRVILLE ROAD ROCKFORD, IL 61125 | VISION SERVICE PLAN | $986 | — | $986 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHERN ILLINOIS HEALTH PLAN EIN 36-2467041 SERVICE PROVIDER | Insurance services Service code 23 | — | $29K |
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 | 334 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 210 | $437K |
| Vision | VISION SERVICE PLAN | 162 | $20K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 334 | $305K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 334 | $305K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 334 | $305K |
| Other | DEARBORN NATIONAL | 292 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 334 | — |
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.