| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 29.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $710 | $710 | 2.08% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 6.02% |
| GI GOERGE PARENT LP3 | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $549 | $549 | 2.19% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | VISION SERVICE PLAN | $833 | $0 | $833 | 6.75% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $411 | $2K | 19.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $149 | $149 | 1.65% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $879 | $424 | $1K | 14.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $154 | $154 | 1.75% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $704 | $421 | $1K | 15.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PSRENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $153 | $153 | 2.17% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $259 | $164 | $423 | 16.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $60 | $60 | 2.32% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 65 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $34K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $25K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.