| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPOWER BENEFITS INC | 5405 CYPRESS CENTER DR STE 100 TAMPA, FL 33609 | VISION SERVICE PLAN | $178K | $0 | $178K | 9.29% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $10K | $0 | $10K | 0.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE IRVINE, CA 92612 | EXCELLUS BLUE CROSS BLUE SHIELD | $66K | — | $66K | 3.61% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE IRVINE, CA 92612 | AETNA LIFE INSURANCE CO | $1K | $498 | $2K | 14.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 | Claims processing Service code 12 | — | $7.9M |
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 | 18,530 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 128 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 18,658 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 205 | $1.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 12,412 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,412 | — |
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.