| 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 | $6K | $1K | $8K | 12.27% |
| 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 | — | $832 | $832 | 1.30% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.35% |
| 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 | — | $507 | $507 | 1.24% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 19.29% |
| 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 | — | $321 | $321 | 1.22% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 19.94% |
| 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 | — | $326 | $326 | 1.41% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $916 | $4K | 19.13% |
| 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 | — | $262 | $262 | 1.18% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $602 | $2K | 14.78% |
| 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 | — | $172 | $172 | 1.37% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $576 | $3K | 24.94% |
| 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 | — | $165 | $165 | 1.41% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $536 | $3K | 25.10% |
| 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 | — | $153 | $153 | 1.46% |
| HOTCHKISS INSURANCE AGENCY, LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $613 | $3K | 26.21% |
| 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 | — | $175 | $175 | 1.77% |
| HOTCHKISS INSURANCE AGENCY, LLC3 Filed as: HOTCHKISS INSURANCE AGENCY LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | NEW BENEFITS | $472 | — | $472 | 5.56% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $64K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $49K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 62 | $22K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $41K |
| Other(6 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 155 | — |
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.