| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 115 FEDERAL ST BOSTON, MA 021101808 | UNITED HEALTHCARE | $21K | — | $21K | 1.57% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | UNITED HEALTHCARE | $20K | — | $20K | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARILINGTON HEIGHTS, IL 60006 | MUTUAL OF OMAHA | $2K | — | $2K | 5.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 736 S STONE AVE LA GRANGE, IL 60525 | MUTUAL OF OMAHA | — | $2K | $2K | 5.68% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MUTUAL OF OMAHA | $2K | — | $2K | 5.60% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD FL 2 HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA | — | $120 | $120 | 0.40% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | EYEMED VISION | $149K | $63 | $149K | 996.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 115 FEDERAL ST BOSTON, MA 021101808 | EYEMED VISION | $504 | — | $504 | 3.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | MUTUAL OF OMAHA | — | $694 | $694 | 5.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | MUTUAL OF OMAHA | $602 | — | $602 | 5.12% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES INC | 400 WAHSINGTON ST, SUITE 400 BRAINTREE, MA 02184 | MUTUAL OF OMAHA | $574 | — | $574 | 4.88% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD FL 2 HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA | — | $48 | $48 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES , INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | MUTUAL OF OMAHA | $584 | — | $584 | 8.04% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MUTUAL OF OMAHA | $506 | — | $506 | 6.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 736 STONE AVE LA GRANGE, IL 60525 | MUTUAL OF OMAHA | — | $495 | $495 | 6.81% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD FL 2 HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA | — | $29 | $29 | 0.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 470 ATLANTIC AVE BOSTON, MA 02210 | ALTUS DENTAL INSURANCE COMPANY, INC | $2K | — | $2K | — |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | ALTUS DENTAL INSURANCE COMPANY, INC | $2K | — | $2K | — |
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 | 301 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE | 301 | $1.3M |
| Dental | ALTUS DENTAL INSURANCE COMPANY, INC | 174 | $0 |
| Vision | EYEMED VISION | 79 | $15K |
| Life insurance | MUTUAL OF OMAHA | 123 | $12K |
| Long-term disability | MUTUAL OF OMAHA | 123 | $30K |
| Other | MUTUAL OF OMAHA | 29 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.