| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | JOSEPH DELACRUZ 2850 GOLF RD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 2.68% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC DBA EPIC MID | JOHN ANTVELINK 600 EAST 96TH STREET UNIT 400 INDIANAPOLIS, IN 46240 | DELTA DENTAL OF MICHIGAN | $928 | — | $928 | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 11.29% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.69% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.71% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISH PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 11.34% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $916 | $916 | 2.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES WHIPPANY | 2850 GOLF ROAD 4TH FLOOR ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $2K | — | $2K | 7.26% |
| INTEGRO INSURANCE BROKERS3 Filed as: EPIC INSURANCE MIDWEST | PO BOX 80159 INDIANAPOLIS, IN 46280 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $204 | — | $204 | 0.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.21% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.29% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $865 | — | $865 | 4.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NEW JERSEY PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.29% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS, INC | 11711 N MERIDIAN ST STE 700 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $794 | — | $794 | 4.71% |
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 | 243 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 436 | $221K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $91K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $54K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $53K |
| Other(6 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $203K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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.