| 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. | $101K | $20K | $121K | 2.94% |
| JOHNSON, MICHAEL3 | 470 PARK AVE SOUTH NEW YORK, NY 10016 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $80K | $0 | $80K | 1.95% |
| 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 | $6K | $0 | $6K | 3.16% |
| MICHAEL JOHNSON3 | 8 HILLCREST PARK RD OLD GREENWICH, CT 06870 | DELTA DENTAL OF NEW YORK | $6K | $0 | $6K | 2.84% |
| 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 | $10K | $0 | $10K | 7.58% |
| MICHAEL JOHNSON3 | 8 HILLCREST RD OLD GREENWICH, CT 06870 | AXA EQUITABLE LIFE INSURANCE COMPANY | $10K | $0 | $10K | 7.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $54 | $6K | 8.90% |
| MICHAEL JOHNSON3 | 8 HILLCREST PARK RD OLD GREENWICH, CT 068701004 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 30009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $466 | $466 | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $9 | $9 | 0.01% |
| INVESTORS MUTUAL AGENCY INC3 Filed as: INVESTORS STRATEGY CORPORATION | 670 WHITE PLAINS ROAD SCARSDALE, NY 10583 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $4K | $0 | $4K | 7.72% |
| JOHNSON, MICHAEL3 | 8 HILLCREST PARK RD OLD GREENWICH, CT 06870 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $3K | $0 | $3K | 6.44% |
| EMERSON REID LLC3 | 350 5TH AVE SUITE 3700 NEW YORK, NY 10118 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $0 | $1K | $1K | 2.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.85% |
| MICHAEL JOHNSON3 | 166 W PUTNAM AVE GREENWICH, CT 068305241 | VISION SERVICE PLAN | $286 | $0 | $286 | 0.86% |
| JAY Z GERLITZ & ASSOCIATES INC.3 Filed as: JAY Z GERLITZ AND ASSOCIATES INC | 207 BRIARWOOD DR SOMERS, NY 10589 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | $176 | $0 | $176 | 4.21% |
| MICHAEL JOHNSON3 | 8 HILLCREST PARK RD OLD GREENWICH, CT 06870 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | $122 | $0 | $122 | 2.92% |
| 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 | $217 | $89 | $306 | 11.01% |
| JOHNSON, MICHAEL3 | 8 HILLCREST PARK ROAD OLD GREENWICH, CT 06870 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $200 | $0 | $200 | 7.20% |
| 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 | 220 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 463 | $4.3M |
| Dental(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 463 | $4.3M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 149 | $37K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 264 | $118K |
| Short-term disability(2 contracts, 2 carriers) | AXA EQUITABLE LIFE INSURANCE COMPANY | 197 | $183K |
| Long-term disability(2 contracts, 2 carriers) | AXA EQUITABLE LIFE INSURANCE COMPANY | 197 | $183K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 42 | $214K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 264 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 463 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.