| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE ITASCA, IL 60143 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $7K | $7K | 1.20% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 282905494 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $4K | $4K | 0.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE ITASCA, IL 60143 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $4K | $4K | 1.09% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 282905494 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $2K | $2K | 0.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS OF SOUTH CAROLINA EIN 57-0287419 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $3.7M |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 11-2617163 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $104K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 12 | — | $61K |
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 | 2,713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,727 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,208 | $186K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,702 | $554K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,702 | $359K |
| Other | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,702 | $554K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,702 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.