| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST SUITE 1400 SOUTH BEND, IN 46601 | THE NORTH RIVER INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $5K | $20K | 20.08% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.99% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $5K | $18K | 20.21% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.04% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST SUITE 1400 SOUTH BEND, IN 46601 | VISION SERVICE PLAN | $2K | — | $2K | 3.04% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST SUITE 1400 SOUTH BEND, IN 46601 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 12.91% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | PO BOX 1087 WAUSAU, WI 54402 | $422K |
| GIBSON INSURANCE AGENCY INC EIN 35-1116724 BROKER | Other commissions Service code 55 | PO BOX 610 ATT ACCT DEPT PLYMOUTH, IN 46563 | $72K |
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 | 787 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 787 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 379 | $72K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 787 | $148K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 274 | $90K |
| Stop-loss / reinsurancereinsurance | THE NORTH RIVER INSURANCE COMPANY | 500 | $673K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 500 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 787 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.