| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | BERKLEY LIFE & HEALTH INS CO | $103K | $0 | $103K | 13.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | PO BOX 5099 TWIN FALLS, ID 83303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $849 | $0 | $849 | 3.29% |
| WILLIAM KEZELE3 | 4370 STONEBROOK LN IDAHO FALLS, ID 83404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $606 | $0 | $606 | 2.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Other commissions Service code 55 | 2850 GOLF ROAD ROLLINGS MEADOWS, IL 60008 | $107K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $81K |
| HUB INTERNATIONAL MOUNTAIN STATES L BROKER | Other commissions Service code 55 | PO BOX 5099 TWIN FALLS, ID 83303 | $849 |
| WILLIAM KEZELE ADMINISTRATOR | Other commissions Service code 55 | 4370 STONEBROOK LN IDAHO FALLS, ID 83404 | $606 |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKLEY LIFE & HEALTH INS CO | 135 | $742K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 20 | $26K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INS CO | 135 | $742K |
| Other(2 contracts, 2 carriers) | BERKLEY LIFE & HEALTH INS CO | 135 | $768K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.