| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDAN CENTRE BLVD. SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUECROSS BLUESHIELD | $43K | — | $43K | 4.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $6K | $12K | 6.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PROVIDIUM GRP SUITE 100 100 MERIDIAN CENTRE BLVD ROCHESTER, NY 14618 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC | ARTHUR J. GALLAGHER AND CO. STE 300 400 MIDLAND DRIVE MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | MUTUAL OF OMAHA INSURANCE COMPANY | $6K | $632 | $7K | 22.07% |
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 | 221 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 149 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $180K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $180K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 221 | $63K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 221 | $93K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 221 | $63K |
| Prescription drug(2 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 149 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.