| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | UNKNOWN TARENTUM, PA 15084 | HIGHMARK, INC. | $24K | $0 | $24K | 2.00% |
| NATHAN MACIOCE3 | UNKNOWN TARENTUM, PA 15084 | HIGHMARK, INC. | $7K | $0 | $7K | 0.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $748 | $7K | 11.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $144 | $2K | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $9 | $9 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | UNKNOWN 4TH FLOOR ROLLING MEADOWS, IL 60008 | AMERICAN UNITED LIFE INSURANCE COMPANY | $2K | $1K | $3K | 9.04% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN SUITE 1200 HUNT VALLEY, MD 21031 | AMERICAN UNITED LIFE INSURANCE COMPANY | $908 | $0 | $908 | 2.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | HEARTLAND | $760 | $0 | $760 | 6.79% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HEARTLAND | $360 | $0 | $360 | 3.22% |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 183 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 169 | $58K |
| Vision | HEARTLAND | 155 | $11K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 156 | $38K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 156 | $38K |
| Prescription drug | HIGHMARK, INC. | 183 | $1.2M |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 156 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.