| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 150 NORTH MERIDIAN AVENUE SUITE 3900 CHICAGO, IL 60601 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $82K | $12K | $93K | 3.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | — | $8K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $8K | — | $8K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203318 DALLAS, TX 75320 | VISION SERVICE PLAN | $1K | — | $1K | 5.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 60.00% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: WELLS FARGO INSURANCE | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $752 | — | $752 | 23.87% |
| KEITH WANN4 | 2370 64TH STREET BROOKLYN, NY 11204 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $741 | — | $741 | 23.52% |
| KIMBERLY HAVENS4 Filed as: KIMBERLY B BERGER GROOMS | 231 MEASOWBROOK DRIVE CRANBERRY TOWNSHIP, PA 16066 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $100 | — | $100 | 3.17% |
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 | 356 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 365 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 908 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 375 | $168K |
| Vision | VISION SERVICE PLAN | 269 | $22K |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 356 | $53K |
| Short-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 356 | $53K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 356 | $53K |
| Prescription drug(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 908 | $2.5M |
| Other(3 contracts, 3 carriers) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 356 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 908 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.