| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 9.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 6.52% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $620 | $620 | 0.52% |
| JAMES W. MOORADIAN3 | 6 HIGHLAND ROAD CHARLESTOWN, RI 02813 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $726 | $0 | $726 | 15.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $113 | $113 | 2.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $37 | $37 | 0.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $108 | $0 | $108 | 7.84% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8 | $0 | $8 | 0.58% |
| JAMES ALEXANDER BIANCHI3 | 11 ELKINS STREET, SUITE 450 BOSTON, MA 02127 | FIRST UNUM LIFE INSURANCE COMPANY | $9 | $0 | $9 | 2.39% |
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 | 278 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 455 | $207K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | 378 | $25K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $138K |
| Short-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $138K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $120K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 455 | — |
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.