| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $36K | $2K | $38K | 4.39% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 543 S EVANS ST GREENVILLE, NC 27858 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 0.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 3655 NOBEL DR STE 450 SAN DIEGO, CA 921221071 | VISION SERVICE PLAN | $3K | — | $3K | 7.51% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $702 | — | $702 | 1.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 3655 NOBEL DRIVE STE 450 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $852 | — | $852 | 6.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $557 | $557 | 4.54% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $375 | — | $375 | 3.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3655 NOBEL DRIVE STE 450 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $386 | — | $386 | 7.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $262 | $262 | 5.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 750 B STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $133 | — | $133 | 2.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3655 NOBEL DRIVE STE 450 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $358 | — | $358 | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $277 | $277 | 5.42% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 750 B STE 450 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $153 | — | $153 | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 3655 NOBEL DRIVE STE 450 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $225 | — | $225 | 7.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $167 | $167 | 5.20% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $96 | — | $96 | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 3655 NOBEL DRIVE STE 450 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $151 | — | $151 | 6.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $122 | $122 | 5.64% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 750 B ST STE 2400 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $66 | — | $66 | 3.05% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 235 | $861K |
| Vision | VISION SERVICE PLAN | 107 | $42K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 10 | $5K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.