| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 200 SOUTH ORANGE AVE SUITE 1350 ORLANDO, FL 32801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 8.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.42% |
| CORPORATE SYNERGIES GROUP LLC3 | ORLANDO LOCATION 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 3.68% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DRIVE STE 200 CAMDEN, NJ 081031000 | HUMANA INSURANCE COMPANY | $847 | — | $847 | 1.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | STE 300 3510 N CAUSEWAY BLVD METAIRIE, LA 700023531 | HUMANA INSURANCE COMPANY | $154 | — | $154 | 0.33% |
| US BENTEC WORKPLACE SOLUTIONS3 Filed as: US BENTEC WORKPLACE SOLUTIONS LLC | 99 WOOD AVE S STE 501 ISELIN, NJ 088302715 | RELIASTAR LIFE INSURANCE COMPANY | $2K | — | $2K | 12.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 5 ROLLING MEADOWS, IL 600084050 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $423 | $2K | 10.45% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES, INC. | 5000 DEARBORN CIR STE 100 MOUNT LAUREL, NJ 080544108 | RELIASTAR LIFE INSURANCE COMPANY | $839 | — | $839 | 4.71% |
| ADP INC3 Filed as: ADP, INC. | PO BOX 842875 BOSTON, MA 022842875 | RELIASTAR LIFE INSURANCE COMPANY | — | $599 | $599 | 3.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | RELIASTAR LIFE INSURANCE COMPANY | $168 | — | $168 | 0.94% |
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 | 90 | 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) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 68 | $47K |
| Vision | HUMANA INSURANCE COMPANY | 68 | $47K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $63K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $63K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $63K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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.