| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | HARVARD PILGRIM HEALTH CARE | $36K | $0 | $36K | 3.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $0 | $2K | 2.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | $0 | $1K | 2.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 12TH FLOOR BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 13.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $640 | $0 | $640 | 10.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $551 | $0 | $551 | 35.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $49 | $49 | 3.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | UNUM INSURANCE COMPANY | $51 | $0 | $51 | 5.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $13 | $13 | 1.30% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 119 | $989K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 89 | $67K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 82 | $6K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $38K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $38K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 119 | $989K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.