| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 100 MATSONFORD RD. 4 RADNOR CORPORATE CTR STE 510 RADNOR, PA 190874559 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JOHN HANCOCK EIN 04-1414660 NONE | Investment management Service code 28 | — | $1.4M |
| BCBSNC EIN 57-0287419 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Contract Administrator; Claims processing Service code 12 | — | $921K |
| AON HEWITT EIN 22-2232264 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $782K |
| NATIONAL LIFE INSURANCE CO. EIN 03-0144090 NONE | Insurance services; Investment management Service code 23 | — | $65K |
| JP MORGAN CHASE BANK, NA EIN 04-3304111 NONE | Trustee (bank, trust company, or similar financial institution); Contract Administrator; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $29K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Contract Administrator; Claims processing Service code 12 | — | $26K |
| RUSSELL INVESTMENT GROUP EIN 04-3581074 NONE | Investment advisory (plan) Service code 27 | — | $25K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,103 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,002 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,002 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.