| 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 COMPANY | $2K | $649 | $2K | 13.82% |
| 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 COMPANY | — | $371 | $371 | 2.18% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $796 | $2K | 22.09% |
| 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 COMPANY | — | $227 | $227 | 2.02% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $797 | $2K | 22.15% |
| 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 COMPANY | — | $228 | $228 | 2.05% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $817 | $430 | $1K | 22.91% |
| 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 COMPANY | — | $123 | $123 | 2.26% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $885 | $338 | $1K | 27.65% |
| 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 COMPANY | — | $97 | $97 | 2.19% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $385 | $295 | $680 | 17.67% |
| 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 COMPANY | — | $84 | $84 | 2.18% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $516 | $255 | $771 | 22.43% |
| 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 COMPANY | — | $73 | $73 | 2.12% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $564 | $219 | $783 | 27.78% |
| 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 COMPANY | — | $63 | $63 | 2.23% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 41 | $17K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 29 | $4K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $11K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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.