| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $18K | — | $18K | 11.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 530054204 | RELIASTAR LIFE INSURANCE COMPANY | $13K | — | $13K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | RELIASTAR LIFE INSURANCE COMPANY | $2K | — | $2K | 2.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $9K | — | $9K | 12.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $461 | $461 | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 530050000 | WYSSTA INSURANCE COMPANY INC | $4K | — | $4K | 8.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $264 | $264 | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | DBA WORKSITE COMMUNICATIONS 800 CAPITAL CIRCLE SE UNIT 2 TALLAHASSEE, FL 32301 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 10.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $860 | — | $860 | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $17 | $17 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $204 | $204 | 0.82% |
| WORKSITE COMMUNICATIONS3 | 800 CAPITAL CIRCLE SE UNIT 2 TALLAHASSEE, FL 32301 | ARAG INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 3009 ARLINGTON HEIGHT, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 17.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $543 | — | $543 | 15.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $33 | $33 | 0.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $278K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 NONE | Other commissions Service code 55 | — | $87K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 NONE | Claims processing; Contract Administrator Service code 12 | — | $8K |
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 | 545 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 545 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 204 | $271K |
| Vision | WYSSTA INSURANCE COMPANY INC | 346 | $46K |
| Life insurance(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 545 | $99K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 530 | $59K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 411 | $459K |
| Other(5 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 545 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 545 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.