| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 823221 PHILADELPHIA, PA 19182 | HORIZON HEALTHCARE SERVICES, INC. | $101K | — | $101K | 2.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH, 8TH FLOOR SAINT LOUIS PARK, MN 55426 | USABLE LIFE | $12K | — | $12K | 10.00% |
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST NEWARK, NJ 07105 | USABLE LIFE | — | $6K | $6K | 5.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 190 RIVER ROAD, 1ST FLOOR SUMMIT, NJ 07901 | VISION SERVICE PLAN | $1K | — | $1K | 3.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | VISION SERVICE PLAN | $869 | — | $869 | 3.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 7 GIRALDA FARMS, 2ND FLOOR MADISON, NJ 07940 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $895 | $3K | 25.29% |
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 | 362 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 366 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 318 | $3.8M |
| Dental | HORIZON HEALTHCARE SERVICES, INC. | 318 | $3.8M |
| Vision | VISION SERVICE PLAN | 276 | $28K |
| Life insurance | USABLE LIFE | 362 | $117K |
| Short-term disability | USABLE LIFE | 362 | $117K |
| Long-term disability | USABLE LIFE | 362 | $117K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 318 | $3.8M |
| Other(2 contracts, 2 carriers) | USABLE LIFE | 362 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.