| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $112K | $112K | 4.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM INSTURANCE COMPANY OF AMERICA | $0 | $28K | $28K | 1.59% |
| NORTHERN BENEFITS3 Filed as: NORTHERN BENEFITS LTD | 1233 SHELBURNE RD STE C2A SOUTH BURLINGTON, VT 05403 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $10K | $0 | $10K | 4.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606907219 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $898 | $0 | $898 | 8.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $50 | $50 | 0.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES INC EIN 36-4291971 BROKER | Insurance agents and brokers Service code 22 | 2850 W GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | $209K |
| DELTA DENTAL PLAN OF VERMONT, INC. EIN 03-0219391 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | 12 BACON STREET SUITE B BURLINGTON, VT 054016140 | $196K |
| NORTHERN BENEFITS LTD EIN 13-1898173 BROKER | Insurance agents and brokers Service code 22 | 1233 SHELBURNE RD STE C2A SOUTH BURLINGTON, VT 05403 | $12K |
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 | 3,960 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 85 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,045 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 2,885 | $365K |
| Short-term disability(2 contracts, 2 carriers) | UNUM INSTURANCE COMPANY OF AMERICA | 3,909 | $2.1M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 800 | $475K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,258 | $2.4M |
| Other(2 contracts, 2 carriers) | UNUM INSTURANCE COMPANY OF AMERICA | 3,909 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,909 | — |
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."
No prospect flags tripped on this filing.