| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | ANTHEM BLUE CROSS | $64K | $986 | $65K | 3.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 115 FEDERAL STREET BOSTON, MA 02110 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $17K | $2K | $20K | 2.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $14K | $0 | $14K | 15.00% |
| ARCHON LLC3 Filed as: ARCHON, LLC | 225 WIRELESS BOULEVARD HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 4.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 4.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 12.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 115 FEDERAL STREET, SUITE 800 BOSTON, MA 02110 | ACE AMERICAN INSURANCE COMPANY | $285 | $20 | $305 | 21.40% |
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 | 172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 302 | $2.6M |
| Dental | ANTHEM BLUE CROSS | 302 | $1.8M |
| Vision | ANTHEM BLUE CROSS | 302 | $1.8M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $96K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $96K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $96K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 302 | $2.6M |
| Other(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
No prospect flags tripped on this filing.