| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES, INC. | ROUND TABLE STUDIOS BERKELEY HEIGHTS, NJ 07922 | KEYSTONE HEALTH PLAN | $31K | $1K | $32K | 6.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES, INC. | ROUND TABLE STUDIOS BERKELEY HEIGHTS, NJ 07922 | INDEPENDENCE BLUE CROSS | $10K | $899 | $11K | 5.65% |
| EXUDE BENEFITS GROUP INC3 Filed as: EXUDE BENEFITS GROUP, INC. | 325 CHESTNUT STREET, SUITE 1000 PHILADELPHIA, PA 19106 | DELTA DENTAL OF PENNSYLVANIA | $3K | $0 | $3K | 10.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 325 CHESTNUT STREET, SUITE 1000 PHILADELPHIA, PA 19106 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $882 | $3K | 14.77% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | ROUND TABLE STUDIOS, SUITE 1000 200 CONNELL DRIVE BERKELEY HEIGHTS, NJ 07922 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $392 | $392 | 2.12% |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KEYSTONE HEALTH PLAN | 54 | $662K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 77 | $31K |
| Vision(2 contracts, 2 carriers) | KEYSTONE HEALTH PLAN | 54 | $662K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $18K |
| Prescription drug(2 contracts, 2 carriers) | KEYSTONE HEALTH PLAN | 54 | $662K |
| Other(3 contracts, 3 carriers) | KEYSTONE HEALTH PLAN | 173 | $680K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.