| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE EAST SUITE 1600 CLEVELAND, OH 44114 | INDEPENDENT HEALTH BENEFITS CORPORATION | $5K | $0 | $5K | 3.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | EYEMED VISION CARE | $972 | $0 | $972 | 11.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $441 | $0 | $441 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $165 | $165 | 3.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | NATIONAL INCENTIVES 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | — |
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 | 202 | 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) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 114 | $360K |
| Dental | MEDICAL MUTUAL OF OHIO | 114 | $230K |
| Vision | EYEMED VISION CARE | 129 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 202 | $4K |
| Prescription drug(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 114 | $360K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 114 | $360K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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."
No prospect flags tripped on this filing.