| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $37K | $37K | 5.21% |
| FOSTER BENEFIT RESOURCES INC3 Filed as: FOSTER BENEFIT RESOURCES INC. | 15660 DALLAS PKWY STE 500 DALLAS, TX 752483354 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 2.17% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $590 | $8K | 10.79% |
| 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 | — | $262 | $262 | 0.35% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $514 | $6K | 16.40% |
| 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 | — | $229 | $229 | 0.62% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $505 | $6K | 16.42% |
| 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 | — | $224 | $224 | 0.63% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $218 | $2K | 11.51% |
| 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 | — | $97 | $97 | 0.67% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $140 | $2K | 21.40% |
| 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 | — | $62 | $62 | 0.62% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $144 | $2K | 21.58% |
| 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 | — | $64 | $64 | 0.71% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | MEDICAL AIR SERVICES ASSOCIATION, INC. | $2K | — | $2K | 20.00% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $106 | $2K | 21.47% |
| 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 | — | $47 | $47 | 0.66% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $924 | $101 | $1K | 16.64% |
| 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 | — | $45 | $45 | 0.73% |
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 | 234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 122 | $719K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $75K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $43K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $36K |
| Other(7 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.