| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVE 3RD FL NEW YORK, NY 10177 | OXFORD HEALTH INSURANCE, INC | $120K | $4K | $124K | 4.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 600084036 | DELTA DENTAL OF NEW YORK | $12K | $0 | $12K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SE | 2245 TEXAS DR #140 SUGAR LAND, TX 77479 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $21K | $0 | $21K | 18.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $64 | $2K | 4.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $687 | $687 | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 600084036 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS | 545 METRO PL S SUITE 435 DUBLIN, OH 43017 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $2K | $0 | $2K | 29.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 600084036 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $498 | $99 | $597 | 17.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WAGEWORKS, INC. EIN 94-3351864 NONE | Claims processing; Contract Administrator 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 | 196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE, INC | 423 | $3.2M |
| Dental | DELTA DENTAL OF NEW YORK | 424 | $208K |
| Vision | VISION SERVICE PLAN | 172 | $31K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 300 | $46K |
| Short-term disability(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 215 | $124K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 215 | $119K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 43 | $187K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 300 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.