| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PL 14TH FLR ITASCA, IL 60143 | TOKIO MARINE | $44K | — | $44K | 12.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO LINCOLN CENTRE 5420 LBJ FWY DALLAS, TX 752406222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 4.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO LINCOLN CENTRE 5420 LBJ FWY DALLAS, TX 752406222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO LINCOLN CENTRE 5420 LBJ FWY DALLAS, TX 752406222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Direct payment from the plan; Float revenue; Claims processing Service code 12 | — | $1.4M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $217K |
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 | 459 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 408 | $367K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 488 | $357K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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.