| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | HORIZON HEALTHCARE SERVICES, INC. | $57K | $0 | $57K | 5.00% |
| BRIAN FISHER3 Filed as: BRIAN J. FISHER | 112 MOORES ROAD, SUITE 100 MALVERN, PA 19355 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 5.10% |
| THOMAS CHRISTOPHER SMITH3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $605 | $89 | $694 | 0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 85 CHESTNUT RIDGE ROAD, SUITE 214 MONTVALE, NJ 07645 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $605 | $0 | $605 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $203 | $0 | $203 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $10 | $10 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 7.00% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | UNITEDHEALTHCARE INSURANCE COMPANY | $103 | $0 | $103 | 0.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $769 | $0 | $769 | 7.33% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | VISION SERVICE PLAN | $240 | $0 | $240 | 2.29% |
| THOMAS CHRISTOPHER SMITH3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $197 | $2K | 44.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 85 CHESTNUT RIDGE ROAD, SUITE 214 MONTVALE, NJ 07645 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 40.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $98 | $98 | 2.02% |
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 | 268 | 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) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 119 | $1.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 125 | $34K |
| Vision | VISION SERVICE PLAN | 99 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 758 | $151K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 52 | $5K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 758 | $146K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 119 | $1.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 758 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 758 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.