| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | BLUE CROSS BLUE SHIELD OF TEXAS | $57K | $596 | $57K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SER-AUSTIN | 2850 GOLF ROAD 5TH FL ROLLING MDWS, IL 600084050 | HUMANA INSURANCE COMPANY | $12K | $4K | $16K | 12.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | AUSTIN PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2580 GOLF RD GBS FINANCE-5TH FL ROLLING MEADOWS, IL 600084042 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $783 | $783 | 3.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $64 | $3K | 15.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $424 | $424 | 2.09% |
| MARSH & MCLENNAN AGENCY LLC3 | 2500 CITYWEST BLVD STE 2400 HOUSTON, TX 770423031 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $58 | $58 | 0.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | AUSTIN PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD GBS FINANCE-5TH FL ROLLING MEADOWS, IL 600084042 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $634 | $634 | 3.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | AUSTIN PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2580 GOLF RD GBS FINANCE-5TH FL ROLLING MEADOWS, IL 600084042 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $380 | $380 | 3.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | AUSTIN PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2580 GOLF RD GBS FINANCE-5TH FL ROLLING MEADOWS, IL 600084042 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $295 | $295 | 3.34% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 328 | $1.2M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 417 | $143K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $17K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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.