| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MT. LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 0.94% |
| HARVARD PRINTING GROUP5 | C/O NEWTEK BUSINESS CREDIT PO BOX 380 FAIRFIELD, NJ 07004 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $423 | $423 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 400 MIDLAND DRIVE SUITE 300 MT. LAUREL, NJ 08054 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $18K | — | $18K | 9.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MATSONFORD ROAD RADNOR CORP CENTER RADNOR, PA 19087 | ZURICH AMERICAN INSURANCE COMPANY | $4K | — | $4K | 5.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUE CROSS BLUE SHIELD EIN 23-1294723 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $2.0M |
| EXPRESS SCRIPTS EIN 22-3461740 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $555K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $162K |
| BENEFIT PLAN ADMINISTRATORS, INC. EIN 54-1419753 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $140K |
| THE HARTFORD CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 GRIFFIN ROAD NORTH WINDSOR, CT 06095 | $59K |
| BENEFIT COORDINATORS CORPORATION EIN 25-1453488 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $9K |
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 | 4,649 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,681 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | ANTHEM BLUE CROSS BLUE SHIELD | 106 | $1.2M |
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 15 | $202K |
| Vision(3 contracts, 3 carriers) | EYEMED | 8,622 | $956K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 9,263 | $1.9M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 4,235 | $1.1M |
| Stop-loss / reinsurancereinsurance | HIGHMARK CASUALTY INSURANCE COMPANY | 4,637 | $168K |
| Other(3 contracts, 3 carriers) | MAGELLAN BEHAVIORAL HEALTH | 8,450 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,263 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.