| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 555 S PERRYVILLE RD ROCKFORD, IL 611082530 | BLUECROSS BLUESHIELD OF ILLINOIS | $28K | — | $28K | 2.42% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | BLUECROSS BLUESHIELD OF ILLINOIS | $18K | — | $18K | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 95287 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | — | $3K | 4.39% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 3.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 555 S PERRYVILLE RD ROCKFORD, IL 61108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.67% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 6.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 555 S PERRYVILLE ROAD ROCKFORD, IL 61108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.68% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $635 | $635 | 2.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 555 S PERRYVILLE RD ROCKFORD, IL 61108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.69% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $399 | $399 | 2.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 555 S PERRYVILLE RD ROCKFORD, IL 61108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.47% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 8.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $333 | $333 | 2.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, LLC. | PO BOX 95287 CHICAGO, IL 606945287 | VISION SERVICE PLAN | $542 | — | $542 | 5.45% |
| STUMM INSURANCE LLC3 | 9400 W HIGGINS RD, STE 310 ROSEMONT, IL 60018 | VISION SERVICE PLAN | $321 | — | $321 | 3.23% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA EASECENTRAL | 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 891352958 | VISION SERVICE PLAN | $113 | — | $113 | 1.14% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 171 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 97 | $64K |
| Vision | VISION SERVICE PLAN | 91 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $18K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $28K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 171 | $1.1M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.