| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 6200 SOUTH SYRACUSE WAY, SUITE 220 GREENWOOD VILLAGE, CO 80111 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | $0 | $19K | 1.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | $0 | $26K | 8.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 3.31% |
| PAYCOM PAYROLL LLC5 Filed as: PAYCOM PAYROLL, LLC | 7501 WEST MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | DELTA DENTAL OF COLORADO | $13K | $0 | $13K | 15.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.60% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD, SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $150 | $0 | $150 | 0.50% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 187 | $1.1M |
| Dental | DELTA DENTAL OF COLORADO | 227 | $88K |
| Vision | VISION SERVICE PLAN | 136 | $30K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $286K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $286K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $286K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 187 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $286K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.