| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITEDHEALTHCARE INSURANCE COMPANY | $65K | $0 | $65K | 2.66% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $31K | $31K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $2K | $2K | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $9K | $0 | $9K | 6.96% |
| DAVID J MCCLELLAN3 Filed as: DAVID J. MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $210 | $4K | 3.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 MADISON AVENUE, 28TH FLOOR NEW YORK, NY 10017 | FIRST UNUM LIFE INSURANCE COMPANY | $935 | $0 | $935 | 0.76% |
| MATTHEW GOLD3 | 68-37 INGRAM STREET FOREST HILLS, NY 11375 | FIRST UNUM LIFE INSURANCE COMPANY | $224 | $0 | $224 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $78 | $78 | 0.06% |
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 | 372 | 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) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 322 | $2.5M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 322 | $2.5M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 322 | $2.5M |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 309 | $123K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 309 | $123K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 322 | $2.5M |
| Other(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 372 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.