| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 3.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 21ST FLOOR TWO PIERCE PLACE ITASCA, IL 60143 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $428 | $428 | 1.25% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | STE 100 800 PARKER HILL DR ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $363 | $30 | $393 | 1.15% |
| GCG FINANCIAL LLC3 Filed as: BENEFIT ADVISORS NETWORK/ALERA | 6830 COCHRAN RD SOLON, OH 44139 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | STE 100 800 PARKER HILL DR ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 16.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 21ST FLOOR TWO PIERCE PLACE ITASCA, IL 60143 | FIRST UNUM LIFE INSURANCE COMPANY | $46 | $0 | $46 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $13 | $13 | 0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 NONE | Claims processing Service code 12 | — | $244K |
| LIFETIME BENEFIT SOLUTIONS NONE | Contract Administrator; Claims processing Service code 12 | 300 MAIN ST. EAST ROCHESTER, NY 14445 | $20K |
| WEX HEALTH INC., A WEX COMPANY NONE | Claims processing; Contract Administrator Service code 12 | 4321 20TH AVE S FARGO, ND 58103 | $12K |
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 | 741 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 16 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 759 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE CO. | 741 | $424K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 692 | $339K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 692 | $339K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 692 | $373K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO. | 741 | $400K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 692 | $396K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 741 | — |
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.