| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | BLUECROSS BLUESHIELD OF TEXAS | $181K | $14K | $195K | 2.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $17K | $17K | 5.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 9442 NORTH CAPITAL OF TEXAS HIGHWAY PLAZA 1, SUITE 950 AUSTIN, TX 78759 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 4.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4201 WESTOWN PARKWAY, SUITE 120 WEST DES MOINES, IA 50266 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19K | $0 | $19K | 11.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18K | $0 | $18K | 10.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | $0 | $29 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 6.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 9442 NORTH CAPITAL OF TEXAS HIGHWAY PLAZA 1, SUITE 950 AUSTIN, TX 78759 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.78% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION, INC. | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $0 | $6K | 11.89% |
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 | 804 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 808 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 1,240 | $7.7M |
| Dental | BLUECROSS BLUESHIELD OF TEXAS | 1,240 | $7.7M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 560 | $53K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 740 | $460K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 740 | $307K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 740 | $307K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 1,240 | $7.7M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 740 | $478K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,240 | — |
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.