| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 50 BRAINTREE HILL OFFICE PARK SUITE 310 BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $5K | $38K | $43K | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 CROWN COLONY DRIVE, SUITE 308 QUINCY, MA 02169 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24K | $4K | $28K | 10.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2315 ENTERPRISE DRIVE, SUITE 105 WESTCHESTER, IL 60154 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 2.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | DELTA DENTAL OF RHODE ISLAND | $7K | — | $7K | 2.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $3K | — | $3K | 8.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 CROWN COLONY DRIVE, SUITE 308 QUINCY, MA 02169 | VISION SERVICE PLAN | $319 | — | $319 | 0.83% |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 484 | $2.9M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 617 | $274K |
| Vision | VISION SERVICE PLAN | 218 | $38K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 345 | $276K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 345 | $276K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 345 | $276K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 484 | $2.9M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 345 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.