| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARTFORD LIFE AND ACCIDENT | $18K | $0 | $18K | 2.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 PEARL STREET, 10TH FLOOR HARTFORD, CT 06103 | DELTA DENTAL OF NJ, INC. | $9K | $0 | $9K | 1.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 022102208 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES, INC | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARTFORD LIFE AND ACCIDENT | $6K | $0 | $6K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $555K |
| WILLIAM GALLAGHER ASSOCIATES EIN 04-2787509 BROKER | Other commissions Service code 55 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | $0 |
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 | 733 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 814 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 686 | $718K |
| Dental | DELTA DENTAL OF NJ, INC. | 708 | $828K |
| Vision | VISION SERVICE PLAN | 558 | $76K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 814 | $868K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 814 | $868K |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 814 | $905K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 814 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.