| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | BLUE CROSS & BLUE SHIELD OF ARIZONA | $51K | $161 | $51K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1345 E. CHANDLER BLVD., BLDG 1-103 PHOENIX, AZ 85048 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $408 | $5K | 2.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1345 E. CHANDLER BLVD., BLDG 1-103 PHOENIX, AZ 85048 | AMERITAS LIFE INSURANCE CORP | $4K | $983 | $5K | 7.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 18.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $766 | $766 | 1.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 16.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $465 | $465 | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1345 E. CHANDLER BLVD., BLDG 1-103 PHOENIX, AZ 85048 | UNITEDHEALTHCARE INSURANCE COMPANY | $648 | — | $648 | 2.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 22.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $712 | $712 | 2.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 W LOOP S STE 1600 HOUSTON, TX 77027 | UNION SECURITY INSURANCE COMPANY | $3K | — | $3K | 15.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $905 | $374 | $1K | 14.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $140 | $140 | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1345 E. CHANDLER BLVD., BLDG 1-103 PHOENIX, AZ 85048 | PRINCIPAL FINANCIAL GROUP AKA EMPLOYERS DENTAL SERVICES | $563 | — | $563 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1345 E. CHANDLER BLVD., BLDG 1-103 PHOENIX, AZ 85048 | METROPOLITAN LIFE INSURANCE COMPANY | $777 | — | $777 | 32.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $79 | $79 | 3.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1345 E. CHANDLER BLVD. PHOENIX, AZ 85048 | JORGENSEN HEALTHCARE ASSO. INC. DBA JORGENSEN BROOKS GROUP | — | $6K | $6K | — |
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 | 291 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ARIZONA | 162 | $1.3M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 305 | $78K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ARIZONA | 305 | $1.2M |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $51K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 66 | $26K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $31K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF ARIZONA | 162 | $1.1M |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.