| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER INS SERVICES INC | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | COMMUNITY INSURANCE COMPANY | $24K | — | $24K | 3.62% |
| ENROLLEASE3 Filed as: ONEDIGITAL EXPRESSLINK LLC | 4200 ROCKSIDE ROAD SUITE 103 CLEVELAND, OH 44131 | COMMUNITY INSURANCE COMPANY | — | $8K | $8K | 1.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BENEFITS SVCS | 750 WARRENVILLE ROAD #400 LISLE, IL 60532 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 9.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER INS SERVICES INC | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $460 | $460 | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER INS SERVICES INC | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $148 | $148 | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER INS SERVICES INC | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $143 | $143 | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER INS SERVICES INC | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $731 | — | $731 | 9.99% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $110 | $110 | 1.50% |
| CHARLES BACKUS3 | 1903 RIVEREDGE DRIVE ASTOR, FL 32102 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $403 | — | $403 | 10.76% |
| MICHAEL J KOST3 | 1025 GALSWORTHY DRIVE AKRON, OH 44313 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $34 | — | $34 | 0.91% |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 89 | $649K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 97 | $47K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 97 | $47K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $31K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $10K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.