| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 221 WEST 6TH STREET, SUITE 1980 AUSTIN, TX 78701 | BLUE CROSS BLUE SHIELD OF TEXAS | $47K | $5K | $52K | 3.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 221 WEST 6TH STREET, SUITE 1980 AUSTIN, TX 78701 | AMERITAS LIFE INSURANCE CORPORATION | $6K | — | $6K | 3.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 50 BRAINTREE HILL OFFICE PARK SUITE 310 BRAINTREE, MA 02184 | AMERITAS LIFE INSURANCE CORPORATION | — | $762 | $762 | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 221 WEST 6TH STREET, SUITE 1980 AUSTIN, TX 78701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 9.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 71542 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.19% |
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 | 366 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 667 | $1.6M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 567 | $171K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 567 | $171K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 374 | $154K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 374 | $154K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 374 | $154K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS | 667 | $1.6M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 374 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 667 | — |
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.