| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $122K | $52 | $122K | 4.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | $7K | $2K | $9K | 6.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $6K | $0 | $6K | 9.36% |
| CORI SHAI HABER3 | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $4K | $2K | $6K | 8.85% |
| KEITH LEPACK3 | 1991 BROADWAY, APARTMENT 12B NEW YORK, NY 10023 | AFLAC | $2K | $387 | $2K | 2.94% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $1K | $387 | $2K | 2.34% |
| DANIELLE L. SCHOFS & OTHERS3 | 215 EAST 68TH STREET, APARTMENT 9S NEW YORK, NY 10901 | AFLAC | $80 | $0 | $80 | 0.12% |
| JASON G DENIVO3 Filed as: JASON G. DENIVO | 199 WATER STREET, 23TH FLOOR NEW YORK, NY 10038 | AFLAC | $48 | $0 | $48 | 0.07% |
| JANELLE MARIE GADOMSKI3 | 48 FAIRVIEW AVENUE PARK RIDGE, NJ 07656 | AFLAC | $15 | $0 | $15 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $2K | — | $2K | 8.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN GENERAL INSURANCE COMPANY | $903 | $120 | $1K | 10.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5420 LYNDON B JOHNSON FREEWAY SUITE 400 DALLAS, TX 75240 | METROPOLITAN GENERAL INSURANCE COMPANY | $0 | $11 | $11 | 0.11% |
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 | 279 | 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) | 279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 264 | $2.8M |
| Dental | AETNA LIFE INSURANCE COMPANY | 264 | $2.8M |
| Vision | VISION SERVICE PLAN | 158 | $22K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 279 | $141K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 279 | $141K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 279 | $141K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 264 | $2.8M |
| Other(3 contracts, 3 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 279 | $220K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.