| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD GBS FINANCE 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF INDIANA | $6K | $118 | $6K | 9.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | CINCINNATI P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 220 EMERSON PLACE SUITE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $354 | $354 | 1.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVENUE SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $230 | $230 | 1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | CINCINNATI P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 220 EMERSON PLACE SUITE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $302 | $302 | 1.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $202 | $202 | 1.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | CINCINNATI P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 220 EMERSON PLACE SUITE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $287 | $287 | 1.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $131 | $131 | 0.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | CINCINNATI P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 220 EMERSON PLACE SUITE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $254 | $254 | 1.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $196 | $196 | 1.27% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 0 | $0 |
| Dental | DELTA DENTAL OF INDIANA | 204 | $68K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 0 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $32K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 77 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 59 | $19K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.