| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 12444 POWERSCOURT DR., STE 500 SAINT LOUIS, MO 63131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $33K | — | $33K | 9.09% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 2.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD., 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 1.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 12444 POWERSCOURT DRIVE ST. LOUIS, MO 63131 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 10.40% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 300 S. JEFFERSON AVE SUITE 600-N SPRINGFIELD, MO 65806 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $135 | $135 | 0.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 300 S JEFFERSON AVE SUITE 600-N SPRINGFIELD, MO 65806 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $450 | $27 | $477 | 12.08% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $142 | — | $142 | 3.59% |
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 | 780 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 782 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 26 | $57K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 520 | $362K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 780 | $20K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 520 | $362K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 520 | $362K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,281 | $933K |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 780 | $424K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,281 | — |
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."
No prospect flags tripped on this filing.