| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $64K | — | $64K | 9.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD 9TH FL ROLLING MEADOWS, IL 60008 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD 9TH FL ROLLING MEADOWS, IL 60008 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 2.14% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $241 | $6K | 28.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS | 70 NE LOOP 410 STE 325 SAN ANTONIO, TX 78216 | METROPOLITAN LIFE INSURANCE COMPANY | $120 | — | $120 | 0.56% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METROPOLITAN LIFE INSURANCE COMPANY | $739 | — | $739 | 15.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS | 70 NE LOOP 410 STE 325 SAN ANTONIO, TX 78216 | METROPOLITAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 INSURANCE PROVIDER | Float revenue; Participant communication; Direct payment from the plan; Other services; Named fiduciary; Contract Administrator; Claims processing; Non-monetary compensation Service code 12 | 280 TRUMBULL ST 5 HARTFORD, CT 06103 | $256K |
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 | 290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 694 | $0 |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 318 | $220K |
| Short-term disability(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 296 | $37K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 213 | $97K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 649 | $649K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 694 | — |
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.