| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE CO. | $3K | $1K | $5K | 13.36% |
| 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 CO. | $0 | $669 | $669 | 1.92% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE CO. | $7K | $2K | $8K | 30.50% |
| 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 CO. | $0 | $517 | $517 | 1.86% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE CO. | $3K | $2K | $5K | 16.70% |
| 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 CO. | $0 | $526 | $526 | 1.91% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE CO. | $0 | $2K | $2K | 6.71% |
| 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 CO. | $0 | $484 | $484 | 1.92% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE CO. | $806 | $545 | $1K | 16.77% |
| 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 CO. | $0 | $156 | $156 | 1.94% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE CO. | $598 | $399 | $997 | 16.68% |
| 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 CO. | $0 | $114 | $114 | 1.91% |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE CO. | 63 | $35K |
| Vision | UNITED OF OMAHA LIFE INSURANCE CO. | 54 | $6K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO. | 117 | $36K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE CO. | 117 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO. | 117 | $27K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO. | 117 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.