| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | ROBERT P SCHWEIGER 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $22K | $511 | $23K | 3.35% |
| MISSOURI VALLEY INSURANCE INC.3 | 112 W THAYER AVE. BISMARCK, ND 58501 | SANFORD HEALTH PLAN | $9K | — | $9K | 5.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ATTN FRED FIGGE ITASCA, IL 60143 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $794 | $794 | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $288 | $4K | 13.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $136 | $2K | 15.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $131 | $1K | 10.98% |
| MARK EUGENE PRINCE3 | 2958 ANTLER CIRCLE FREMONT, NE 68025 | PRINCIPAL LIFE INSURANCE COMPANY | $695 | — | $695 | 6.00% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 850182151 | PRINCIPAL LIFE INSURANCE COMPANY | $432 | — | $432 | 3.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10050 REGENCY CIR STE 300 OMAHA, NE 681143721 | PRINCIPAL LIFE INSURANCE COMPANY | $314 | — | $314 | 2.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $310 | $27 | $337 | 13.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $188 | $19 | $207 | 11.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $32 | $3 | $35 | 11.04% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | MEDICA INSURANCE COMPANY | 168 | $1.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 38 | $12K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 147 | $43K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 147 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 147 | $14K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 147 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.