| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | HM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | HM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 444 LIBERTY AVENUE 4 GATEWAY CENTER PITTSBURGH, PA 15222 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 444 LIBERTY AVENUE 4 GATEWAY CENTER PITTSBURGH, PA 15222 | LIFE INSURANCE COMPANY OF AMNERICA | $0 | $1K | $1K | 1.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 444 LIBERTY AVENUE 4 GATEWAY CENTER PITTSBURGH, PA 15222 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $101 | $101 | 1.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. EIN 23-1294723 | Contract Administrator Service code 13 | 1800 CENTER STREET CAMPHILL, PA 17081 | $119K |
| UPMC BENEFIT MANAGEMENT SERVICES EIN 25-1769564 | Contract Administrator Service code 13 | US STEEL TOWER 600 GRANT STREET PITTSBURGH, PA 15219 | $53K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 | Contract Administrator Service code 13 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | $21K |
| LIFE INSURANCE COMPANY OF NA EIN 23-1503749 | Contract Administrator Service code 13 | PO BOX 20643 LEHIGH VALLEY, PA 18002 | $17K |
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 | 367 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 367 | $63K |
| Long-term disability | LIFE INSURANCE COMPANY OF AMNERICA | 349 | $55K |
| Stop-loss / reinsurancereinsurance(2 contracts) | HM LIFE INSURANCE COMPANY | 205 | $614K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 307 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.