| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRACKBILL BENEFITS LLC3 Filed as: BRACKBILL, ANDREW | 244 SILVERWOOD DRIVE LITITZ, PA 17543 | STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK | — | — | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $41 | $3K | 4.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | SUITE 500 3600 AMERICAN BLVD W BLOOMINGTON, MN 55431 | HIGHMARK BLUE SHIELD | $488 | — | $488 | 2.73% |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 202 | $65K |
| Vision | HIGHMARK BLUE SHIELD | 199 | $18K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 190 | $79K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 190 | $79K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 190 | $79K |
| Prescription drug | STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 146 | $182K |
| Stop-loss / reinsurancereinsurance | STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 146 | $182K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 285 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.