| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE FLOOR 14 ATTN ANNA CRIBARI ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $41 | $41 | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $27 | $27 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE FLOOR 14 ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $10 | $10 | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 444 LIBERTY AVENUE SUITE 805 PITTSBURGH, PA 15222 | VISION BENEFITS OF AMERICA | $134 | $0 | $134 | 8.02% |
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 | 173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 342 | $0 |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $7K |
| Vision | VISION BENEFITS OF AMERICA | 161 | $2K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $5K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $5K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $5K |
| Prescription drug | HIGHMARK | 342 | $0 |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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.