| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 1 JERICHO PLZ STE 200 JERICHO, NY 11753 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MDWS, IL 600084036 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $8K | $8K | 2.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 1 JERICHO PLZ STE 200 JERICHO, NY 11753 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $2.0M |
| GALLAGHER BENEFIT SERVICES, INC NONE | Consulting fees; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 60008 | $174K |
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 | 3,903 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 125 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,041 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,190 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,190 | $2.0M |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 3,879 | $701K |
| Long-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,153 | $396K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,190 | $2.0M |
| Other(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,190 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,190 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.