| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2005 MARKET STREET, SUITE 820 PHILADELPHIA, PA 19103 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 2.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $252 | $10K | 5.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $2K | $14K | 9.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $2K | — | $2K | 3.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE MOUNT LAUREL, NJ 08054 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $209 | $0 | $209 | 0.96% |
| ADVANCED VOLUNTARY CONCEPTS INC3 Filed as: ADVANCED VOLUNTARY CONCEPTS, INC. | 75 SOUTH BROADWAY, 4TH FLOOR WHITE PLAINS, NY 10601 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $88 | $0 | $88 | 0.41% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVENUE POINT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.02% |
| POLHEMUS STORMIE M3 | 6 SAVANNAH ROAD JACKSON, NJ 08527 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.02% |
| GSA CARIBBEAN CORPORATION3 | P O BOX 367306 SAN JUAN, PR 00936 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
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 | 333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 30 | $241K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 504 | $197K |
| Vision | VISION SERVICE PLAN | 225 | $59K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 333 | $173K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 333 | $151K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 333 | $151K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 30 | $241K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 504 | $351K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.