| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $2K | $6K | 9.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 85 CHESTNUT RIDGE ROAD SUITE 214 MONTVALE, NJ 07645 | FIRST UNUM LIFE INSURANCE COMPANY | $522 | — | $522 | 0.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 85 CHESTNUT RIDGE ROAD SUITE 124 MONTVALE, NJ 07645 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 7.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | — | $467 | $467 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | HM LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF NEW YORK | $791 | — | $791 | 3.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $653 | $3K | 13.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $580 | $3K | 13.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERIVES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF NEW YORK | $8K | — | $8K | — |
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 | 508 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF NEW YORK | 400 | $26K |
| Vision | HM LIFE INSURANCE COMPANY | 459 | $27K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 508 | $63K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 37 | $23K |
| Long-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 508 | $102K |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 508 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.