| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE, SUITE 300 MT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $41K | $74K | $115K | 1.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 75 JOHN ROBERTS ROAD, BUILDING C S PORTLAND, ME 04106 | AETNA LIFE INSURANCE COMPANY | $30K | $39K | $69K | 0.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $2K | $0 | $2K | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $152 | $0 | $152 | 0.30% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $18 | $0 | $18 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 13.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $947 | $0 | $947 | 2.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $907 | $0 | $907 | 8.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21ST FLOOR, TWO PIERCE PLACE ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $197 | $0 | $197 | 1.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $125 | $125 | 1.14% |
| USI INSURANCE SERVICES LLC3 | 123 INTERSTATE DRIVE WEST SPRINGFIELD, MA 01809 | NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA | $290 | $0 | $290 | 14.99% |
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 | 489 | 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) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Vision | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Other(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 1,150 | $8.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,150 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.