| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.5 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.5 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL INSURANCE COMPANY | $3K | $28K | $31K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Other fees; Direct payment from the plan; Claims processing; Float revenue Service code 12 | — | $770K |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $116K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Other commissions Service code 55 | — | $17K |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE CO. | 163 | $286K |
| Dental | DELTA DENTAL INSURANCE COMPANY | 163 | $0 |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 156 | $27K |
| Stop-loss / reinsurancereinsurance(2 contracts) | BERKLEY LIFE AND HEALTH INSURANCE CO. | 163 | $259K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.