| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 | P.O. BOX 11107 FORT WAYNE, IN 46855 | CIGNA HEALTH AND LIFE INSURANCE COMPANY(CIGNA) | $15K | — | $15K | 9.77% |
| GIBSON INSURANCE AGENCY, INC.3 | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $5K | $18K | 20.49% |
| FMLASOURCE INC3 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 5.91% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| GIBSON INSURANCE AGENCY, INC.3 | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 19.08% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| GIBSON INSURANCE AGENCY, INC.3 | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $3K | $13K | 19.42% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| GIBSON INSURANCE AGENCY, INC.3 | PO BOX 11177 FORT WAYNE, IN 468551107 | VISION SERVICE PLAN | $1K | — | $1K | 3.22% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 S MICHIGAN ST, STE 1400 SOUTH BEND, IN 46601 | VISION SERVICE PLAN | $343 | — | $343 | 0.83% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 208142554 | VISION SERVICE PLAN | $51 | — | $51 | 0.12% |
| GIBSON INSURANCE AGENCY, INC.3 | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $686 | $2K | 21.36% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $539 | $539 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. CLAIMS PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services Service code 12 | — | $140K |
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 | 378 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY(CIGNA) | 378 | $149K |
| Vision | VISION SERVICE PLAN | 311 | $41K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 484 | $97K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $71K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $66K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 484 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.