| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 13.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $800 | $800 | 2.18% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 22.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $513 | $513 | 2.15% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.32% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $421 | $421 | 1.81% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $600 | $2K | 20.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $267 | $267 | 2.46% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY #2000 CARROLLTON, TX 75007 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 12.53% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY #2000 CARROLLTON, TX 75007 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $760 | — | $760 | 8.05% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $688 | $2K | 22.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $196 | $196 | 2.16% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $825 | $634 | $1K | 17.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $181 | $181 | 2.19% |
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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 73 | $37K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $11K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.