| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P. O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $14K | $14K | 1.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3 RADNOR CORPORATE CTR STE 100 WAYNE, PA 190874516 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALIGHT EIN 82-1061233 NONE | Plan Administrator; Consulting (general) Service code 14 | — | $1.3M |
| JOHN HANCOCK EIN 13-3072894 NONE | Investment management Service code 28 | — | $1.2M |
| BCBSNC EIN 57-0287419 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Insurance agents and brokers Service code 12 | — | $751K |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Contract Administrator; Claims processing Service code 12 | — | $178K |
| NATIONAL LIFE INSURANCE EIN 03-0144090 NONE | Insurance services; Investment management Service code 23 | — | $82K |
| JP MORGAN CHASE BANK, NA EIN 13-4994650 NONE | Trustee (directed) Service code 25 | — | $11K |
| ERNST & YOUNG U.S. LLP EIN 34-6565596 NONE | Accounting (including auditing) Service code 10 | — | $9K |
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 | 2,009 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,009 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $941K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 839 | — |
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.