| 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 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $196K | $0 | $196K | 5.49% |
| 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 SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 60008 | AXA EQUITABLE LIFE INSURANCE COMPANY | $18K | $0 | $18K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $75 | $14K | 23.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $764 | $764 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MATSONFORD RD 4 RADNOR CORPORATE CTR STE 510 RADNOR, PA 190874559 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $6 | $6 | 0.01% |
| 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 | 4.54% |
| 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 | $592 | $66 | $658 | 16.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WAGEWORKS, INC. EIN 94-3351864 NONE | Claims processing; Contract Administrator Service code 12 | — | $3K |
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 | 232 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 396 | $3.8M |
| Dental | DELTA DENTAL OF NEW YORK | 427 | $205K |
| Vision | VISION SERVICE PLAN | 164 | $32K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 292 | $60K |
| Short-term disability | AXA EQUITABLE LIFE INSURANCE COMPANY | 232 | $122K |
| Long-term disability | AXA EQUITABLE LIFE INSURANCE COMPANY | 232 | $122K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 50 | $233K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 292 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 427 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.