| 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 | $41K | — | $41K | 1.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 400 MIDLAND DRIVE SUITE 300 MT. LAUREL, NJ 08054 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $4K | — | $4K | 5.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $3K | — | $3K | 2.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4 RADNOR CORPORATE CENTER SUITE 510 RADNOR, PA 19087 | ACE AMERICAN INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. EIN 23-1294723 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.5M |
| EXPRESS SCRIPTS EIN 22-3461740 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $453K |
| BUSINESSOLVER.COM, INC. EIN 42-1503807 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $382K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $208K |
| THE HARTFORD CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 GRIFFIN ROAD NORTH WINDSOR, CT 06095 | $193K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $114K |
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 | 3,818 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,826 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,647 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HIGHMARK INC. | 98 | $506K |
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 2 | $88K |
| Vision(2 contracts, 2 carriers) | EYEMED | 6,486 | $746K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,888 | $2.4M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,445 | $1.2M |
| Stop-loss / reinsurancereinsurance | HIGHMARK CASUALTY INSURANCE COMPANY | 6,770 | $200K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,888 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,888 | — |
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.