| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $16K | $77K | $93K | 2.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $48K | $6K | $54K | 17.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2056 VISTA PARKWAY, SUITE 300 WEST PALM BEACH, FL 33411 | COMBINED INSURANCE | $2K | $0 | $2K | 15.51% |
| PREPARE BENEFITS, LLC3 | UNKNOWN DOVER, OH 44622 | COMBINED INSURANCE | $1K | $0 | $1K | 10.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2056 VISTA PARKWAY, SUITE 300 WEST PALM BEACH, FL 33411 | COMBINED INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 23.70% |
| PREPARE BENEFITS, LLC3 | UNKNOWN DOVER, OH 44622 | COMBINED INSURANCE COMPANY OF AMERICA | $716 | $0 | $716 | 14.64% |
| ANDREW JENNINGS3 | UNKNOWN DOVER, OH 44622 | COMBINED INSURANCE COMPANY OF AMERICA | $127 | $0 | $127 | 2.60% |
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 | 224 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.5M |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 414 | $315K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 414 | $310K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 414 | $310K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.5M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 414 | $322K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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.