| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N. CLARK ST SUITE 1100 CHICAGO, IL 60654 | UNITEDHEALTHCARE INSURANCE COMPANY | $53K | — | $53K | 9.55% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N. CLARK ST SUITE 1100 CHICAGO, IL 60654 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 7.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.69% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N. CLARK ST SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 16.51% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N. CLARK ST SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 16.80% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N. CLARK ST SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 17.20% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N. CLARK ST SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 17.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $129K |
| MESIROW INSURANCE SERVICE INC. EIN 36-3429604 BROKER | Other commissions Service code 55 | 353 N. CLARK ST STE 1100 CHICAGO, IL 606543454 | $0 |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $78K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 640 | $551K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $57K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $24K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 640 | $551K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 640 | — |
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.