| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDATLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | AMERICAN FIDELITY ASSURANCE COMPANY | $772K | — | $772K | 11.33% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $109K | — | $109K | 1.60% |
| MJ INSURANCE3 Filed as: CT AUTOMOTIVE AND VARIOUS AGENTS | 856 RIVER ROAD HARTFORD, CT 06103 | AMERICAN FIDELITY ASSURANCE COMPANY | $276 | $7K | $7K | 0.10% |
| NJ CAR SERVICES, INC.3 Filed as: NJ CAR SERVICE, INC. | 856 RIVER ROAD TRENTON, NJ 08628 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 0.10% |
| AZ AUTO DEALTERS ASSOC., SVCS., INC3 | UNKNOWN PHOENIX, AZ 85064 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $3K | $3K | 0.04% |
| GROUP CONSULTING, INC.3 | 2035 STATE ROUTE 27, SUITE 1080 EDISON, NJ 08817 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 0.04% |
| RI AUTOMOTIVE AUTO DEALERS3 | 335-D CENTERVILLE ROAD WARWICK, RI 02886 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $2K | $2K | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | DELTA DENTAL OF MICHIGAN | $73K | — | $73K | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN INC | $130K | — | $130K | 5.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1800 CHAPEL AVENUE WEST, SUITE 160 CHERRY HILL, NJ 08002 | SIMNSA | $25K | — | $25K | 4.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1800 CHAPEL AVENUE WEST, SUITE 160 CHERRY HILL, NJ 08002 | DENTEGRA INSURANCE COMPANY | $5K | — | $5K | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $17K | $734 | $18K | 10.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1800 CHAPEL AVENUE WEST, SUITE 160 CHERRY HILL, NJ 08002 | HEALTH PLAN OF NEVADA | $6K | — | $6K | 5.54% |
| HOWARD DARWIN3 Filed as: HOWARD M. DARWIN | 5214 68TH STREET, SUITE 100 LUBBOCK, TX 79424 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $7K | $309 | $7K | 10.47% |
| STEPHEN H LONG3 Filed as: STEPHEN LONG | 5214 68TH STREET, SUITE 100 LUBBOCK, TX 79424 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $7K | $309 | $7K | 10.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 501 FELLOWSHIP ROAD, SUITE 201 MOUNT LAUREL, NJ 08054 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 4.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | — | $447 | $447 | 0.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 1687 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $290 | $290 | 0.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | GOLDEN WEST HEALTH PLAN, INC. | $4K | — | $4K | 8.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1800 CHAPEL AVENUE WEST, SUITE 160 CHERRY HILL, NJ 08002 | EMPLOYERS DENTAL SERVICE | $3K | — | $3K | 8.00% |
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 | 10,887 | 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) | 10,887 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 4,871 | $10.0M |
| Dental(5 contracts, 5 carriers) | DELTA DENTAL OF MICHIGAN | 9,537 | $3.9M |
| Vision | VISION SERVICE PLAN | 4,964 | $586K |
| Life insurance(5 contracts, 5 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 10,887 | $7.1M |
| Short-term disability(3 contracts, 3 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 4,871 | $6.9M |
| Long-term disability(4 contracts, 4 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 4,871 | $6.9M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 373 | $3.2M |
| Other(3 contracts, 3 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 10,887 | $7.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,887 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.