| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 6.59% |
| 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 | — | $985 | $985 | 1.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 7.45% |
| 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 | — | $485 | $485 | 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. | P.O. BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| 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 | — | $352 | $352 | 1.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| 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 | — | $323 | $323 | 1.35% |
| 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 | $644 | — | $644 | 3.00% |
| 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 | $7K | — | $7K | — |
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 | 484 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 484 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF NEW YORK | 413 | $21K |
| Vision | HM LIFE INSURANCE COMPANY | 453 | $26K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 484 | $65K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 42 | $24K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 255 | $72K |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 484 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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.