| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE ITASCA, IL 60143 | LIBERTY MUTUAL ASSURANCE OF BOSTON | $158K | $62K | $220K | 4.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUE CROSS BLUE SHIELD EIN 23-1294723 | Claims processing Service code 12 | FIFTH AVENUE PLACE PITTSBURGH, PA 15222 | $3.1M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $2.3M |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 | Claims processing Service code 12 | N19 W24130 RIVERWOOD DRIVE WAUKESHA, WI 53188 | $297K |
| UNITED CONCORDIA COMPANIES INC. EIN 25-1687586 | Claims processing Service code 12 | 4401 DEER PATH ROAD HARRISBURG, PA 17110 | $259K |
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 | 14,155 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 14,155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 9,238 | $1.2M |
| Life insurance | LIBERTY MUTUAL ASSURANCE OF BOSTON | 14,155 | $5.3M |
| Short-term disability | LIBERTY MUTUAL ASSURANCE OF BOSTON | 14,155 | $5.3M |
| Long-term disability | LIBERTY MUTUAL ASSURANCE OF BOSTON | 14,155 | $5.3M |
| Stop-loss / reinsurancereinsurance | HIGHMARK CASUALTY INSURANCE COMPANY | 9,940 | $785K |
| Other(2 contracts, 2 carriers) | LIBERTY MUTUAL ASSURANCE OF BOSTON | 14,155 | $5.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,155 | — |
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."
No prospect flags tripped on this filing.