| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC NY | PO BOX 95287 CHICAGO, IL 606945287 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $200K | $200K | 7.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC NY | PO BOX 95287 CHICAGO, IL 606945287 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $31K | $31K | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $26K | — | $26K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | VISION SERVICE PLAN | $11K | — | $11K | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $6K | — | $6K | 3.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $578 | $578 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT RESOURCE, LLC NONE | Contract Administrator; Claims processing Service code 12 | 245 KENNETH DR ROCHESTER, NY 14623 | $130K |
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 NONE | Contract Administrator Service code 13 | — | $32K |
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 | 2,602 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,618 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,300 | $2.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,300 | $2.7M |
| Vision | VISION SERVICE PLAN | 1,570 | $224K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 2,602 | $46K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 920 | $319K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 2,522 | $179K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,300 | $2.7M |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,602 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,602 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.