| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVENUE STE 1700 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $41 | $8K | 3.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2 PIERCE PL FL 14 ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | — | $100 | $100 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1100 SUPERIOR AVE STE 1700 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $41 | $5K | 4.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL FL 14 ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | — | $52 | $52 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE STE 1601 CLEVELAND, OH 44114 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 14.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1111 SUPERIOR AVENUE STE 1601 CLEVELAND, OH 44114 | STANDARD INSURANCE COMPANY | $226 | — | $226 | 1.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $151 | — | $151 | 0.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $205K |
| GALLAGHER BENEFIT SERVICES CORP EIN 36-4291971 BROKER | Other commissions Service code 55 | 1100 SUPERIOR AVENUE STE 1700 CLEVELAND, OH 44114 | $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 | 422 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $227K |
| Vision | EYEMED VISION CARE | 292 | $19K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $227K |
| Long-term disability | STANDARD INSURANCE COMPANY | 44 | $16K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 422 | $260K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 243 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.