| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $27K | $27K | 1.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINA BEACH, VA 234662937 | METROPOLITAN LIFE INSURANCE COMPANY | — | $89 | $89 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVE, FL 13 BOSTON, MA 022102205 | METROPOLITAN LIFE INSURANCE COMPANY | — | $63 | $63 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV | 12647 ALCOSTA BLVD, STE 330 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 7.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $470K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 CONSULTING SERVICES | Consulting (general) Service code 16 | — | $72K |
| STERLING WELLNESS SOLUTIONS, LLC WELLNESS ADMINISTRATOR | Insurance services Service code 23 | 210 WEST MILL STREET CROWLEY, LA 70526 | $71K |
| USI INSURANCE SERVICES LLC CONSULTING SERVICES | Consulting (general) Service code 16 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | $59K |
| DIRECT PATH CONSULTING SERVICES | Consulting (general) Service code 16 | 120 18TH STREET, SOUTH BIRMINGHAM, AL 35233 | $35K |
| PAYFLEX ADMINISTRATION | Contract Administrator Service code 13 | 13511 LABEL LANE, SUITE 201 HAGERSTOWN, MD 21740 | $29K |
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 | 969 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 969 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,804 | $496K |
| Vision | EYEMED VISION CARE | 2,034 | $120K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,806 | $418K |
| Short-term disability | STANDARD INSURANCE COMPANY | 1,806 | $418K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,806 | $418K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 984 | $1.6M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,806 | $490K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,034 | — |
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."
No prospect flags tripped on this filing.