| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF WYOMING | $3K | $0 | $3K | 4.95% |
| PEAK1 ADMINISTRATION3 | UNKNOWN JACKSON, WY 83001 | VSP | $1K | $0 | $1K | 13.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6300 SOUTH SYRACUSE WAY, SUITE 700 CENTENNIAL, CO 80111 | VSP | $1K | $0 | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 16.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $113 | $113 | 1.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6300 SOUTH SYRACUSE WAY, SUITE 700 CENTENNIAL, CO 80111 | MADISON NATIONAL LIFE INSURANCE COMPANY | $393 | $0 | $393 | 14.86% |
| NORTH AMERICAN BENEFITS COMPANY5 | 220 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | $0 | $231 | $231 | 8.74% |
| DEANNA M CHRISTENSEN3 Filed as: DEANNA CHRISTENSEN AND OTHER AGENTS | PO BOX 2175 ROCK SPRINGS, WY 82902 | AFLAC | $107 | $0 | $107 | 5.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $60 | $0 | $60 | 2.93% |
| DAWN D SHEUE3 Filed as: DAWN D. SHEUE | PO BOX 3986 JACKSON, WY 83001 | AFLAC | $53 | $0 | $53 | 2.59% |
| ROBERT J. WOODSON3 | PO BOX 945 WILSON, WY 83014 | AFLAC | $45 | $0 | $45 | 2.20% |
| BRENDEN CRAFT3 | 3790 NORTH BALDWIN AVENUE IDAHO FALLS, ID 83401 | AFLAC | $42 | $0 | $42 | 2.05% |
| LOGAN JACK HERRING-STEGELMEIER3 | 110 NORTH 4600 EAST RIGBY, ID 83442 | AFLAC | $42 | $0 | $42 | 2.05% |
| THOMAS E SHEUE3 Filed as: THOMAS E. SHEUE | PO BOX 3986 JACKSON, WY 83001 | AFLAC | $39 | $0 | $39 | 1.91% |
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 | 102 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WYOMING | 86 | $51K |
| Vision | VSP | 102 | $11K |
| Life insurance | MADISON NATIONAL LIFE INSURANCE COMPANY | 104 | $3K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 21 | $8K |
| Other(2 contracts, 2 carriers) | MADISON NATIONAL LIFE INSURANCE COMPANY | 104 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.