| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | $43K | $1K | $45K | 2.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE, SUITE 1601 CLEVELAND, OH 44114 | COMP BENEFITS | $3K | — | $3K | 4.90% |
| ROBERTSON RYAN & ASSOCIATES3 Filed as: ROBERTSON AGENCY | 10725 PINE VALLEY CIRCLE PAINSESVILLE, OH 44077 | COMP BENEFITS | $25 | — | $25 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE, SUITE 1601 CLEVELAND, OH 44114 | UNITED OF OMAHA LIFE INSURACNE COMPANY | $5K | $2K | $6K | 11.12% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE, SUITE 1601 CLEVELAND, OH 44114 | UNITED OF OMAHA LIFE INSURACNE COMPANY | $3K | — | $3K | 8.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE, SUITE 1601 CLEVELAND, OH 44114 | COMP BENEFITS | $1K | — | $1K | 9.98% |
| DAWSON INSURANCE3 | 1340 DEPOT STREET SUITE 300 CLEVELAND, OH 44116 | ZURICH AMERICAN INSURANCE COMPANY | $799 | — | $799 | 14.98% |
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 | 187 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | 144 | $1.5M |
| Dental | COMP BENEFITS | 85 | $60K |
| Vision | COMP BENEFITS | 67 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURACNE COMPANY | 175 | $37K |
| Long-term disability | UNITED OF OMAHA LIFE INSURACNE COMPANY | 175 | $55K |
| Prescription drug | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | 144 | $1.5M |
| Other(3 contracts, 3 carriers) | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | 187 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.