| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 887 WEST MARIETTA STRET NORTH 108 ATLANTA, GA 30318 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $72K | — | $72K | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $21K | — | $21K | 1.98% |
| DOMINIUM BENEFITS, LLC3 | 3500 LENOX ROAD NORTHEAST SUITE 1600 ATLANTA, GA 30326 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3820 REDSTONE COURT SMYNA, GA 30080 | DELTA DENTAL OF TENNESSEE | $19K | — | $19K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2 PIERCE PLACE ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | $30K | $3K | $33K | 21.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | VISION SERVICE PLAN | $5K | — | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 887 WEST MARIETTA STREET ATLANTA, GA 30318 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 887 WEST MARIETTA STREET ATLANTA, GA 30318 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 887 WEST MARIETTA STREET STUDIO N108 ATLANTA, GA 30318 | SYMETRA FINANCIAL | $6K | — | $6K | 10.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $2K | $200 | $2K | 9.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 887 WEST MARIETTA STREET ATLANTA, GA 30318 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
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 | 1,233 | 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) | 1,233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 898 | $6.2M |
| Dental | DELTA DENTAL OF TENNESSEE | 1,067 | $380K |
| Vision | VISION SERVICE PLAN | 609 | $102K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 5,427 | $151K |
| Short-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 223 | $96K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,872 | $72K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 5,427 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,427 | — |
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.