| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $14K | $14K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 5.66% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 28.05% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 24.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 11.43% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 21.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 INSURANCE PROVIDER | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | 280 TRUMBULL ST 5 HARTFORD, CT 06103 | $330K |
| AETNA BEHAVIORAL HEALTH LLC EIN 20-0446713 PLAN ADMINISTRATOR | Claims processing; Plan Administrator; Contract Administrator Service code 12 | 151 FARMINGTON AVENUE RSAA HARTFORT, CT 06156 | $6K |
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 | 346 | 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) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 120 | $51K |
| Dental | DELTA DENTAL INSURANCE COMPANY | 739 | $0 |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 339 | $237K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 234 | $34K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 346 | $111K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 729 | $759K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 739 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.