| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $96K | $5K | $101K | 1.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE NEW YORK, NY 10177 | AETNA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 3.52% |
| A C EDWARDS INC.3 Filed as: A.C. EDWARDS, INC. | 140 GREENE AVENUE SAYVILLE, NY 11782 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 6.32% |
| THE D B L CENTER LTD3 Filed as: D.B.L. CENTER, LTD | 155 PINELAWN ROAD, SUITE 120S MELVILLE, NY 11747 | HARTFORD LIFE AND ACCIDENT | $0 | $7K | $7K | 5.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 13.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $2K | $2K | 7.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 5.49% |
No Schedule C service providers reported on this filing.
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 443 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 681 | $6.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 590 | $247K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 854 | $25K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 443 | $186K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 101 | $30K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 443 | $132K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 681 | $6.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 854 | — |
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.