| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8200 NW 41ST ST STE 200 MIAMI, FL 331666204 | SYMETRA LIFE INSURANCE COMPANY | $35K | — | $35K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & COALLAGHER | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | — | $25K | $25K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4350 W CYPRESS ST SUITE 300 TAMPA, FL 33607 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $30K | $14K | $44K | 6.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 30150 TELEGRAPH RD STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | — | $6K | — |
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 | 1,126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,280 | $0 |
| Dental | DELTA DENTAL OF MICHIGAN | 2,301 | $612K |
| Vision | EYEMED VISION CARE | 2,159 | $142K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $666K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $666K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $666K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,280 | $0 |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 2,280 | $1.0M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $666K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,301 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.