| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 201629 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $2K | $18K | 16.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 10050 REGENCY CIR SUITE 300 OMAHA, NE 68114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $176 | $176 | 0.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 201629 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $927 | $927 | 1.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 10050 REGENCY CIR SUITE 300 OMAHA, NE 68114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $83 | $83 | 0.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 201629 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $539 | $539 | 1.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 10050 REGENCY CIR SUITE 300 OMAHA, NE 68114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $50 | $50 | 0.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 201629 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $130 | $130 | 1.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 10050 REGENCY CIR SUITE 300 OMAHA, NE 68114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $12 | $12 | 0.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 201629 DALLAS, TX 75320 | MUTUTAL OF OMAHA INSURANCE COMPANY | $217 | — | $217 | 15.03% |
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 | 642 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 642 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 642 | $135K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 355 | $48K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 642 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 642 | — |
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.