| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $79K | $0 | $79K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 100 MERIDIAN CETRE BLVD. SUITE 100 ROCHESTER, NY 14618 | MVP HEALTH CARE | $20K | $0 | $20K | 4.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD. SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $8K | $0 | $8K | 6.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PL ITASCA, IL 601431203 | VISION SERVICE PLAN | $724 | $0 | $724 | 7.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 100 MERIDIAN CENTRE BLVD. SUITE 100 ROCHESTER, NY 14618 | MVP HEALTH CARE | $314 | $0 | $314 | 3.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD. SUITE 100 ROCHESTER, NY 14618 | MVP HEALTH CARE | $300 | $0 | $300 | 8.65% |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 4 carriers) | EXCELLUS BLUE CROSS BLUE SHIELD | 132 | $2.8M |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 142 | $121K |
| Vision | VISION SERVICE PLAN | 81 | $9K |
| Prescription drug(7 contracts, 4 carriers) | EXCELLUS BLUE CROSS BLUE SHIELD | 132 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.