| 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 BLUE SHIELD | $75K | — | $75K | 3.49% |
| 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 | — | $8K | 4.91% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DR FARMINGTON, CT 06034 | FIRST UNUM LIFE INSURANCE COMPANY | $16K | $889 | $16K | 14.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 100 MERIDIAN CENTRE BLVD, SUITE 100 ROCHESTER, NY 14618 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 601433141 | HARTFORD LIFE AND ACCIDENT | — | $833 | $833 | 1.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - | 100 MERIDIAN CENTRE BLVD, 100 ROCHESTER, NY 14618 | EYEMED VISION CARE | $3K | — | $3K | 10.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTER, STE 100 ROCHESTER, NY 14618 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $215 | $2K | 18.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $106 | $106 | $212 | 1.60% |
| THE FARMINGTON COMPANY3 Filed as: THE FARMINGTON CO, JILL BORREL | PO BOX 527 FARMINGTON, CT 06034 | LIFE INSURANCE COMPANY OF BOSTON AND NEW YORK | $1K | — | $1K | 9.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $2K | $285 | $2K | 19.05% |
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 | 613 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 613 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 261 | $2.1M |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 309 | $172K |
| Vision | EYEMED VISION CARE | 399 | $26K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 631 | $168K |
| Long-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 23 | $25K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 261 | $2.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 631 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 631 | — |
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.