| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: DIGITAL BENEFIT ADVISORS W LAKE VLG | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.21% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $991 | $8K | $9K | 4.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $847 | — | $847 | 0.47% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.95% |
| WALTZ SHERIDAN CRAWFORD INC.3 Filed as: WALTZ, SHERIDAN, CRAWFORD, INC. | 2000 PACIFIC AVE FOREST GROVE, OR 97116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 7.13% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OREGON LLC | 941 OAK ST EUGENE, OR 97401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.83% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OREGON LLC | 2000 PACIFIC AVE FOREST GROVE, OR 97116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $932 | — | $932 | 2.55% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $595 | $595 | 2.87% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OR LLC | PO BOX 128 FOREST GROVE, OR 97116 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 13.63% |
| WALTZ SHERIDAN CRAWFORD INC.3 Filed as: WALTZ SHERIDAN CRAWFORD INC | P.O. BOX 128 FOREST GROVE, OR 97116 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $260 | — | $260 | 1.38% |
| WALTZ SHERIDAN CRAWFORD INC.3 Filed as: WALTZ, SHERIDAN, CRAWFORD INC. | 2000 PACIFIC AVE FOREST GROVE, OR 97116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $407 | $290 | $697 | 7.10% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OREGON LLC | 941 OAK ST EUGENE, OR 97401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $409 | — | $409 | 4.17% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OREGON LLC | 2000 PACIFIC AVE FOREST GROVE, OR 97116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $166 | — | $166 | 1.69% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $767 | $767 | 8.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $274 | $274 | 3.02% |
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 | 275 | 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) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 165 | $2.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $180K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $180K |
| Life insurance(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $75K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $57K |
| Prescription drug(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 165 | $2.0M |
| Other(5 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 156 | $255K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.