| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | ANTHEM BLUE CROSS | $71K | $307 | $71K | 0.75% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET BOSTON, MA 10982 | ANTHEM BLUE CROSS | $14K | $0 | $14K | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | EMBLEMHEALTH | $131K | $0 | $131K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $24K | $0 | $24K | 7.52% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE 15TH FLOOR NEW YORK, NY 10017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | $0 | $8K | 2.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2005 MARKET ST PHILADELPHIA, PA 19103 | PRUDENTIAL | $381 | $0 | $381 | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTHCARE OF CONNECTICUT, INC | $2K | $0 | $2K | 7.59% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKER INC | 750 THIRD AVENUE 15TH FLOOR NEW YORK, NY 10017 | CIGNA HEALTHCARE OF CONNECTICUT, INC | $537 | $0 | $537 | 2.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA DENTAL HEALTH OF KENTUCKY INC | $846 | $0 | $846 | 7.59% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE 15TH FLOOR NEW YORK, NY 10017 | CIGNA DENTAL HEALTH OF KENTUCKY INC | $268 | $0 | $268 | 2.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA DENTAL HEALTH OF NEW JERSEY INC | $705 | $0 | $705 | 7.59% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKER, INC | 750 THIRD AVENUE 15TH FLOOR NEW YORK, NY 10017 | CIGNA DENTAL HEALTH OF NEW JERSEY INC | $224 | $0 | $224 | 2.41% |
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 | 345 | 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) | 345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 345 | $12.8M |
| Dental(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 391 | $360K |
| Vision | ANTHEM BLUE CROSS | 345 | $9.5M |
| Prescription drug | EMBLEMHEALTH | 97 | $3.3M |
| Other(2 contracts, 2 carriers) | EMBLEMHEALTH | 773 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 773 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.