| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVE 3RD FL NEW YORK, NY 10177 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | $0 | $22K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 21ST FLOOR TWO PIERCE PLACE ITASCA, IL 60143 | STARMOUNT LIFE INSURANCE COMPANY | $905 | $0 | $905 | 2.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $825 | $825 | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 85 CHESTNUT RIDGE RD SUITE 214 MONTVALE, NJ 07645 | STARMOUNT LIFE INSURANCE COMPANY | $415 | $0 | $415 | 1.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3RD FLOOR 250 PARK AVENUE NEW YORK, NY 10177 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 10.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | STE 300 400 MIDLAND DRIVE MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $275 | $0 | $275 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVE FL 3 NEW YORK, NY 101770506 | UNITEDHEALTHCARE INSURANCE COMPANY | $341 | $0 | $341 | 9.96% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 88 | $738K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 33 | $33K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 54 | $3K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 103 | $22K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 103 | $22K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 103 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.