| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $111K | $42K | $153K | 1.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $23K | $0 | $23K | 19.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 7.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $758 | $0 | $758 | 0.82% |
| WORKPLACE SOLUTIONS, INC.3 | 120-A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $337 | $0 | $337 | 0.36% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $260 | $0 | $260 | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $336 | $4K | 10.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 11.15% |
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 | 902 | 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) | 902 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 923 | $7.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 923 | $7.7M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 515 | $29K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 902 | $92K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 136 | $115K |
| Long-term disability(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 902 | $157K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 923 | $7.7M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 902 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 923 | — |
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.