| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | EMBLEMHEALTH | $140K | $0 | $140K | 3.65% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 115 SOUTH JEFFERSON ROAD WHIPPANY, NJ 07981 | AMERIHEALTH INSURANCE COMPANY | $24K | $11K | $35K | 6.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DENTCARE DELIVERY SYSTEMS | $8K | $0 | $8K | 15.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | HEALTHPLEX INSURANCE COMPANY | $5K | $0 | $5K | 10.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 9.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLAND DRIVE SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $132 | $0 | $132 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | HM LIFE INSURANCE COMPANY OF NEW YORK | $3K | $0 | $3K | 10.00% |
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 | 590 | 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) | 590 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEMHEALTH | 540 | $4.4M |
| Dental(2 contracts, 2 carriers) | DENTCARE DELIVERY SYSTEMS | 292 | $105K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 350 | $30K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 590 | $32K |
| Prescription drug(2 contracts, 2 carriers) | EMBLEMHEALTH | 540 | $4.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 590 | — |
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.