| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN NATIONAL | $5K | — | $5K | 8.05% |
| THE VAN DYKE GROUP3 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | DEARBORN NATIONAL | $2K | — | $2K | 4.02% |
| UMR, INC.5 | 150 W WAUSAU AVE WAUSAU, WI 54401 | UNITED HEALTHCARE INSURANCE CO | — | $165K | $165K | 1862.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITED HEALTHCARE INSURANCE CO | $887 | $31K | $32K | 355.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 TPA, CLAIMS PROCESSING | Claims processing Service code 12 | 150 W WAUSAU AVE WAUSAU, WI 54401 | $159K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 AGENT, BROKER | Other commissions Service code 55 | PO BOX 95287 CHICAGO, IL 60694 | $36K |
| THE VAN DYKE GROUP EIN 36-4025371 BROKER, AGENT | Insurance agents and brokers Service code 22 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | $2K |
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. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE CO | 105 | $9K |
| Life insurance | DEARBORN NATIONAL | 120 | $58K |
| Short-term disability | DEARBORN NATIONAL | 120 | $58K |
| Long-term disability | DEARBORN NATIONAL | 120 | $58K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 104 | $390K |
| Other | TOKIO MARINE | 105 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.