| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55426 | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $17K | $17K | 1.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55426 | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $9K | $9K | 1.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55476 | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55426 | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 2.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55426 | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 3.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55426 | HARTFORD LIFE AND ACCIDENT | $743 | — | $743 | 15.01% |
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 | 1,317 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,067 | $154K |
| Life insurance | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,332 | $894K |
| Long-term disability | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,317 | $481K |
| Other(4 contracts, 2 carriers) | CIGNA - LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,317 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,332 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.