| 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 | $75K | — | $75K | 5.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SER-AUSTIN | 2850 GOLF ROAD 5TH FL ROLLING MDWS, IL 600084050 | HUMANA INSURANCE COMPANY | $15K | $5K | $20K | 13.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, TX 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $75 | $2K | 10.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $302 | $302 | 1.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MATSONFORD RD 4 RADNOR CORPORATE CTR STE 510 RADNOR, PA 190874559 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.01% |
| 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 | 220 EMERSON PL STE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $384 | $384 | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $270 | $270 | 1.17% |
| 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 | 220 EMERSON PL STE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $313 | $313 | 1.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $218 | $218 | 1.01% |
| 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 | 220 EMERSON PL STE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $227 | $227 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $101 | $101 | 0.56% |
| 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 | 220 EMERSON PL STE 200 DAVENPORT, IA 52801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $224 | $224 | 1.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $131 | $131 | 0.88% |
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 | 212 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 424 | $1.4M |
| Dental | HUMANA INSURANCE COMPANY | 211 | $148K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 537 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $41K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $22K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 537 | — |
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.