| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FL ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $337K | $0 | $337K | 2.25% |
| CLEARY BENEFITS GROUP, INC.3 Filed as: CLEARY BENEFITS GROUP INC. | 83 WOOSTER HEIGHTS RD DANBURY, CT 06810 | SUN LIFE ASSURANCE COMPANY OF CANADA | $29K | $0 | $29K | 0.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FL ROLLING MEADOWS, IL 60008 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $411 | $0 | $411 | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL | $163 | $0 | $163 | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $9.0M |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $307K |
| HEALTH AND HUMAN RESOURCE CENTER EIN 33-0052273 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $33K |
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 | 15,532 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 15,532 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 14,415 | $996K |
| Vision | AETNA LIFE INSURANCE CO. | 14,415 | $990K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 15,930 | $15.0M |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 15,930 | $15.0M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 15,930 | $15.0M |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 34,000 | $15.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 34,000 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.