| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE SUITE 2100 ITASCA, IL 601431203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $246K | $4K | $250K | 35.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 8.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ARTHUR J. GALLAGHER CO. 400 MIDLAND DR, SUITE 300 MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.45% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $109 | $109 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $755 | — | $755 | 1.40% |
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 | 296 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 75 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 371 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 936 | $714K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 936 | $714K |
| Vision | VISION SERVICE PLAN | 343 | $54K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 292 | $317K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 292 | $317K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 292 | $317K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 936 | $714K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 292 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 936 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.