| 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 | $50K | — | $50K | 8.77% |
| 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 | $6K | — | $6K | 7.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.09% |
| GARY S BASS INC3 | 268 COUNTY ROAD 1743 CHICO, TX 76431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $590 | — | $590 | 15.00% |
| GARY S BASS INC3 | 268 COUNTY ROAD 1743 CHICO, TX 76431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $385 | — | $385 | 14.99% |
| GARY S BASS INC3 | 268 COUNTY ROAD 1743 CHICO, TX 76431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $351 | — | $351 | 15.00% |
| 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 | $23K |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 125 | $79K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 556 | $569K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 17 | $2K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 17 | $3K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 17 | $4K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 556 | $569K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 556 | — |
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.