| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 127 NORTH WALNET ST. ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $28K | — | $28K | 5.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER INSURANCE SVC | 4933 LINCOLN AVE STE 5 LISLE, IL 60532 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $20K | — | $20K | 4.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | CHICAGO 2 PIERCE PL ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.87% |
| GALLAGHER BENEFIT SERVICES, INC.2 Filed as: CONNOR & GALLAGHER BEN SVCS INC | 4933 LINCOLN AVE STE 5 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | CHICAGO 2 PIERCE PL ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BEN SVCS INC | 4933 LINCOLN AVE STE 5 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $770 | — | $770 | 2.13% |
| MID AMERICAN GROUP, INC.3 Filed as: MID AMERICAN GROUP INC | 760 PASQUINELI DRIVE SUITE 358 WESTMONT, IL 60559 | GUARDIAN | $5K | — | $5K | 24.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | CHICAGO 2 PIERCE PL ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $285 | — | $285 | 2.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BEN SVCS INS | 4933 LINCOLN AVE STE 5 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $204 | — | $204 | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | CHICAGO 2 PIERCE PL ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $283 | — | $283 | 2.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BEN SVCS INC | 4933 LINCOLN AVE STE 5 LISLE, IL 60532 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $203 | — | $203 | 2.09% |
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 | 152 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 152 | $492K |
| Dental | GUARDIAN | 118 | $21K |
| Vision | GUARDIAN | 118 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $46K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $47K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $10K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.