| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLD RD ROLLING MEADOWS, IL 60008 | USABLE LIFE | $2K | — | $2K | 15.00% |
| MCCALL, MARTIN3 | 315 CR 782 JONESBORO, AR 72405 | USABLE LIFE | $1K | — | $1K | 9.65% |
| VANDYKE, MARIA3 | 13 PAWNEE CT MAUMELLE, AR 72113 | USABLE LIFE | $158 | — | $158 | 1.06% |
| DUNCAN, JERRY3 | C/O ARKANSAS BCBS 516 E MILLSAP RD FAYETTEVILLE, AR 72703 | USABLE LIFE | $129 | — | $129 | 0.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLD RD ROLLING MEAOWS, IL 60008 | USABLE LIFE | $2K | — | $2K | 15.00% |
| MCCALL, MARTIN3 | 315 CR 782 JONESBORO, AR 72405 | USABLE LIFE | $1K | — | $1K | 10.53% |
| VANDYKE, MARIA3 | 13 PAWNEE CT MAUMELLE, AR 72113 | USABLE LIFE | $150 | — | $150 | 1.16% |
| DUNCAN, JERRY3 | C/O ARKANSAS BCBS 216 EAST MILLSAP RD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $123 | — | $123 | 0.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLD RD ROLLING MEADOWS, IL 60008 | USABLE LIFE | $717 | — | $717 | 15.01% |
| MCCALL, MARTIN3 | 315 CR 782 JONESBORO, AR 72405 | USABLE LIFE | $452 | — | $452 | 9.46% |
| VANDYKE, MARIA3 | 13 PAWNEE CT MAUMELLLE, AR 72113 | USABLE LIFE | $30 | — | $30 | 0.63% |
| DUNCAN, JERRY3 | C/O BLUE CROSS BLUE SHIELD 516 E MILLSAP RD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $24 | — | $24 | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2580 GOLD ROAD ROLLING MEADOWS, IL 60008 | USABLE LIFE | $73 | — | $73 | 14.90% |
| MCCALL, MARTIN3 | 315 CR 782 JONESBORO, AR 72405 | USABLE LIFE | $53 | — | $53 | 10.82% |
| VANDYKE, MARIA3 | 13 PAWNEE CT MAUMELLE, AR 72113 | USABLE LIFE | $6 | — | $6 | 1.22% |
| DUNCAN, JERRY3 | C/O ARKANSAS BCBS 516 E MILLSAP ROAD FAYETTEVILLE, AR 72703 | USABLE LIFE | $5 | — | $5 | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $82K |
| GALLAGHER BENEFIT SERVICES EIN 39-4291971 BROKER | Other commissions Service code 55 | 2580 GOLF RD ROLLING MEADOWS, IL 60008 | $24K |
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 | 118 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD - VISION | 137 | $7K |
| Dental | ARKANSAS BLUE CROSS BLUE SHIELD | 150 | $29K |
| Vision | BLUE CROSS AND BLUE SHIELD - VISION | 137 | $7K |
| Life insurance(2 contracts) | USABLE LIFE | 118 | $18K |
| Short-term disability | USABLE LIFE | 104 | $15K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 108 | $300K |
| Other(2 contracts) | USABLE LIFE | 118 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.