| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $504K | $0 | $504K | 16.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $59K | $59K | 1.88% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $36K | $36K | 1.16% |
| BENIESCAN, INC.5 | 40 BURTON HILLS BOULEVARD SUITE 200 NASHVILLE, TN 37215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $28K | $28K | 0.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | DELTA DENTAL OF TENNESSEE | $174K | $0 | $174K | 8.75% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $32K | $32K | 3.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $5K | $0 | $5K | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | BANKERS FIDELITY LIFE INSURANCE COMPANY | $32K | $0 | $32K | 14.77% |
| WEX HEALTH, INC.3 | 83 HOPMEADOW STREET, SUITE 220 SIMSBURY, CT 06089 | BANKERS FIDELITY LIFE INSURANCE COMPANY | $5K | $0 | $5K | 2.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | LEGALPLANS USA | $26K | $0 | $26K | 15.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE, SUITE 2 HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $92 | $0 | $92 | 37.40% |
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 | 2,853 | 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) | 2,853 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 115 | $1.0M |
| Dental | DELTA DENTAL OF TENNESSEE | 4,301 | $2.0M |
| Vision | VISION SERVICE PLAN | 2,163 | $237K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,853 | $3.4M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,853 | $3.1M |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,853 | $3.1M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 115 | $1.0M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,853 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,301 | — |
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."
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.