| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3 SUMMIT PARK DRIVE, SUITE 530 INDEPENDENCE, OH 44131 | HCC LIFE INSURANCE | $3K | — | $3K | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3 SUMMIT PARK DRIVE, SUITE 530 INDEPENDENCE, OH 44131 | TOKIO MARINE HCC | $4K | — | $4K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3 SUMMIT PARK DRIVE, SUITE 530 INDEPENDENCE, OH 44131 | TOKIO MARINE HCC | $755 | — | $755 | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVE E, STE 1700 CLEVELAND, OH 441142521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $1K | $8K | 13.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 545 METRO PL S, STE 435 DUBLIN, OH 430173386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 8.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVE E, STE 1700 CLEVELAND, OH 441142521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $625 | $5K | 14.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 545 METRO PL S, STE 435 DUBLIN, OH 430173386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVE E, STE 1700 CLEVELAND, OH 441142521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $434 | $3K | 13.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 545 METRO PL S, STE 435 DUBLIN, OH 430173386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVE E, STE 1700 CLEVELAND, OH 441142521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $322 | $3K | 13.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 545 METRO PL S, STE 435 DUBLIN, OH 430173386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.45% |
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 | 193 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HCC LIFE INSURANCE | 203 | $911K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $56K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $59K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 135 | $25K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.