| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY | $60K | $14K | $74K | 2.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | N/A WARREN, NJ 99996 | AETNA LIFE INSURANCE COMPANY | $0 | $115 | $115 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PL 14TH FL ITASCA, IL 60143 | DELTA DENTAL OF NEW YORK, INC. | $16K | $0 | $16K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PL ITASCA, IL 60143 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $15K | $0 | $15K | 16.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $41 | $8K | 13.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $895 | $895 | 1.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL 14TH FLOOR ITASCA, IL 60143 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $656 | $144 | $800 | 18.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | SUITE #435 545 METRO PLACE SOUTH DUBLIN, OH 43017 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $817 | $0 | $817 | 22.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONEXIS EIN 20-0198855 NONE | Contract Administrator; Claims processing Service code 12 | — | $4K |
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 | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | 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) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 515 | $2.8M |
| Dental | DELTA DENTAL OF NEW YORK, INC. | 506 | $267K |
| Vision | VISION SERVICE PLAN | 151 | $32K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 322 | $61K |
| Short-term disability(2 contracts) | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | 232 | $99K |
| Long-term disability | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | 232 | $95K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 322 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 515 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.