| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 95287 CHICAGO, IL 60694 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $32K | — | $32K | 3.56% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: 360 RISK MANAGEMENT INC. | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | — | $26K | 2.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $22K | $22K | 2.54% |
| FMLASOURCE INC3 Filed as: FMLASOURCE INC. | 455 CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13K | $13K | 1.52% |
| UNITED OF OMAHA LIFE INSURANCE CO3 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 1.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $11K | $507 | $12K | 1.87% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: 360 RISK MANAGEMENT, INC. | 21500 HAGGERTY RD NORTHVILLE, MI 48167 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 0.97% |
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 | 784 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 784 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 1,487 | $635K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 784 | $885K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 784 | $885K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 784 | $885K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 850 | $925K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,487 | — |
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.