| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | EMBLEMHEALTH | $286K | $0 | $286K | 3.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $6K | $12K | 6.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $3K | $11K | 13.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 9.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $4K | 9.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. - NY | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $5K | $0 | $5K | 13.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 250 PARK AVE FL 3 NEW YORK, NY 101770506 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 18.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | HARTFORD LIFE AND ACCIDENT | $0 | $194 | $194 | 1.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $169 | $58 | $227 | 13.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE GUARDIAN LIFE INS CO OF AMERICA EIN 13-5123390 NONE | Contract Administrator; Claims processing Service code 12 | — | $38K |
| GALLAGHER BENEFIT SERVICES INC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | $8K |
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 | 928 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 938 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEMHEALTH | 1,052 | $8.6M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 727 | $37K |
| Life insurance(2 contracts) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 928 | $103K |
| Short-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 108 | $83K |
| Long-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 691 | $182K |
| Other(6 contracts, 3 carriers) | EMBLEMHEALTH | 1,052 | $8.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,052 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.