| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | TUFTS INSURANCE COMPANY | $51K | $5K | $56K | 3.26% |
| CHARLES MAHONEY3 | 935 JEFFERSON BLVD. WARWICK, RI 02886 | JOHN HANCOCK LIFE AND HEALTH INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 1900 CROWN COLONY DRIVE STE 308 QUINCY, MA 02169 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 19.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 400 MIDLAND DRIVE MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.39% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $48 | $48 | 0.05% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TUFTS INSURANCE COMPANY | 255 | $1.7M |
| Dental(9 contracts, 2 carriers) | DELTA DENTAL OF RHODE ISLAND | 74 | $0 |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 132 | $117K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 132 | $91K |
| Other(4 contracts, 3 carriers) | JOHN HANCOCK LIFE AND HEALTH INSURANCE COMPANY | 132 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.