| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | INDEPENDENCE BLUE CROSS - PERSONAL CHOICE | $4K | — | $4K | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1800 CHAPEL AVENUE WEST, SUITE 160 CHERRY HILL, NJ 08002 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $42K | $4K | $45K | 13.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE, SUITE 300 MOUNT LAUREL, NJ 08054 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | — | $20K | 12.75% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 8.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $893 | — | $893 | 0.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | INDEPENDENT BLUE CROSS - MEDICARE SUPPLEMENTAL | $3K | — | $3K | 12.29% |
| THOMAS C SMITH3 Filed as: THOMAS C. SMITH | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 32.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 11.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | ARAG INSURANCE COMPANY | $665 | — | $665 | 9.20% |
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 | 346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS - PERSONAL CHOICE | 746 | $3.5M |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 682 | $244K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 504 | $23K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 384 | $489K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 384 | $489K |
| Prescription drug | INDEPENDENCE BLUE CROSS - PERSONAL CHOICE | 746 | $3.5M |
| Other(5 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 384 | $616K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 746 | — |
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."
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.