| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | HORIZON HEALTHCARE SERVICES, INC. | $42K | $0 | $42K | 3.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 7.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.07% |
| THOMAS CHRISTOPHER SMITH3 | PO BOX 40386 NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $582 | $48 | $630 | 2.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 85 CHESTNUT RIDGE ROAD, SUITE 214 MONTVALE, NJ 07645 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $582 | $0 | $582 | 2.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $208 | $208 | 0.76% |
| THOMAS CHRISTOPHER SMITH3 | PO BOX 40386 NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $100 | $1K | 6.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 85 CHESTNUT RIDGE ROAD, SUITE 214 MONTVALE, NJ 07645 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 5.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $45 | $45 | 0.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $634 | $0 | $634 | 5.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $162 | $0 | $162 | 1.43% |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 103 | $1.2M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 96 | $38K |
| Vision | VISION SERVICE PLAN | 89 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 167 | $51K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 53 | $24K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 103 | $1.2M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 167 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.