| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD. SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUESHIELD | $76K | — | $76K | 3.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 GANNETT DRIVE STE 300 WHITE PLAINS, NY 106043404 | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $14K | — | $14K | 10.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | COMPANION LIFE INSURANCE COMPANY | $9K | $6K | $15K | 16.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | MUTUAL OF OMAHA INSURANCE COMPANY | $6K | $4K | $10K | 15.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | MUTUAL OF OMAHA INSURANCE COMPANY | $5K | $3K | $8K | 15.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD GBS FINANCE 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE AND HEALTH INSURANCE COMPANY | $2K | $3K | $5K | 25.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | MUTUAL OF OMAHA INSURANCE COMPANY | $399 | $235 | $634 | 15.87% |
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 | 295 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUESHIELD | 205 | $2.3M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 350 | $161K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 350 | $113K |
| Short-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 350 | $72K |
| Long-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 350 | $80K |
| Prescription drug | EXCELLUS BLUE CROSS BLUESHIELD | 205 | $2.3M |
| Other(3 contracts, 3 carriers) | COMPANION LIFE INSURANCE COMPANY | 350 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.