| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.5 Filed as: UNITED HEALTHCARE SERVICES, INC. | — | ALL SAVERS INSURANCE COMPANY | — | $17K | $17K | 14.18% |
| THE VAN DYKE GROUP3 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | ALL SAVERS INSURANCE COMPANY | $7K | — | $7K | 5.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF RD FL 11 ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $952 | $4K | 13.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $524 | — | $524 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| THE VANDYKE GROUP EIN 36-4025371 AGENT, BROKER | Insurance agents and brokers Service code 22 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | $7K |
| GALLAGER BENEFIT SERVICES, INC. EIN 36-4291971 AGENT, BROKER | Insurance agents and brokers Service code 22 | 2850 GOLF RD FL 11 ROLLING MEADOWS, IL 60008 | $4K |
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 | 29 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 29 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALL SAVERS INSURANCE COMPANY | 20 | $122K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 29 | $26K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 27 | $26K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 29 | $26K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 29 | $26K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 29 | $26K |
| Prescription drug | ALL SAVERS INSURANCE COMPANY | 20 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 29 | — |
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.