| 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 BLUE CROSS BLUE SHIELD | $87K | — | $87K | 2.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDAN CENTRE BLVD, SUITE 100 ROCHESTER, NY 14618 | DELTA DENTAL OF NEW YORK | $21K | — | $21K | 9.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 100 MERIDIAN CTR BLVD STE 100 ROCHESTER, NY 14618 | HARTFORD LIFE INSURANCE CO. | $3K | — | $3K | 7.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 295 WOODCLIFF DRIVE STE 101 FAIRPORT, NY 14450 | HARTFORD LIFE INSURANCE CO. | $1K | — | $1K | 3.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDAN CENTRE BLVD, SUITE 100 ROCHESTER, NY 14618 | EYEMED VISION CARE | $2K | — | $2K | 8.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDAN CENTER STE 100 ROCHESTER, NY 14618 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $3K | $437 | $4K | 37.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $583 | $583 | 5.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVC INC | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | SUN LIFE INSURANCE AND HEALTH INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 18.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVC INC | 50 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | SUN LIFE INSURANCE AND HEALTH INSURANCE COMPANY OF NEW YORK | — | $187 | $187 | 2.46% |
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 | 682 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 691 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 372 | $3.2M |
| Dental | DELTA DENTAL OF NEW YORK | 663 | $230K |
| Vision | EYEMED VISION CARE | 432 | $22K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE CO. | 709 | $49K |
| Long-term disability | SUN LIFE INSURANCE AND HEALTH INSURANCE COMPANY OF NEW YORK | 19 | $8K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 372 | $3.2M |
| Other | HARTFORD LIFE INSURANCE CO. | 709 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 709 | — |
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.
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.