| 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 | $157K | $0 | $157K | 1.46% |
| HPHC INSURANCE AGENCY, INC.3 | 93 WORCESTER STREET WELLESLEY HILLS, MA 02481 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $27K | $0 | $27K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $10K | $18K | 4.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 EAST CARMEL DRIVE, SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $44K | $22K | $65K | 21.97% |
| 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 | 9.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN GENERAL INSURANCE COMPANY | $544 | $0 | $544 | 8.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | METROPOLITAN GENERAL INSURANCE COMPANY | $204 | $0 | $204 | 3.14% |
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 | 996 | 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) | 996 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 973 | $10.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 614 | $447K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 704 | $35K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 996 | $298K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 996 | $298K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 996 | $298K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 973 | $10.8M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 996 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 996 | — |
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.