| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $74K | $7K | $82K | 16.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $903K |
| GALLAGHER BENEFIT SERVICES NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | TWO PIERCE PLACE 14TH FL ITASCA, IL 60143 | $176K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Contract Administrator; Claims processing Service code 12 | — | $70K |
| THE GUARDIAN LIFE INS CO OF AMERICA EIN 13-5123390 NONE | Contract Administrator; Claims processing Service code 12 | — | $30K |
| PAYFLEX SYSTEMS USA, INC. EIN 91-1774434 NONE | Contract Administrator; Claims processing Service code 12 | — | $26K |
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 | 2,316 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 25 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 2,364 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 3,544 | $186K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,351 | $495K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,351 | $495K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,351 | $495K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,544 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.