| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3600 AMERICAN BLVD. SUITE 500 WEST BLOOMINGTON, MN 55431 | HIGHMARK INC. | $14K | — | $14K | 0.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. INC. | 3600 AMERICAN BLVD. SUITE 500 WEST BLOOMINGTON, MN 55431 | UNITED CONCORDIA INSURANCE COMPANY | $4K | $500 | $4K | 4.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 7.98% |
| DIFFENDERFER, DENNIS, R3 | 1120 AUGUSTA CIRCLE NORTH HUNTINGDON, PA 15642 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.20% |
| SMITH, THOMAS, CHRISTOPHER3 | P.O. BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $294 | $3K | 9.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 9.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 16.31% |
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 | 359 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. | 333 | $1.6M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 353 | $100K |
| Vision | HIGHMARK INC. | 333 | $1.6M |
| Life insurance | STANDARD INSURANCE COMPANY | 293 | $18K |
| Short-term disability | STANDARD INSURANCE COMPANY | 176 | $38K |
| Long-term disability | STANDARD INSURANCE COMPANY | 43 | $12K |
| Prescription drug | HIGHMARK INC. | 333 | $1.6M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.