| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 1900 W LOOP S STE 1600 HOUSTON, TX 77027 | AETNA LIFE INSURANCE COMPANY | $50K | — | $50K | 9.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 70 NE LOOP 410 STE 325 SAN ANTONIO, TX 782165849 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $113 | $13K | 9.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $444K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 | Contract Administrator Service code 13 | 21653 NETWORK PLACE CHICAGO, IL 606731216 | $110K |
| FORVIS MAZARS, LLP F/K/A BKD, LLP EIN 44-0160260 | Accounting (including auditing) Service code 10 | 10001 REUNION PLACE SUITE 400 SAN ANTONIO, TX 78216 | $25K |
| WEX HEALTH F/K/A DISCOVERY BENEFITS EIN 90-0058554 | Contract Administrator Service code 13 | 4321 20TH AVENUE S FARGO, ND 58103 | $6K |
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 | 1,162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 58 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 1,274 | $502K |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,274 | $502K |
| Vision | AETNA LIFE INSURANCE COMPANY | 1,274 | $502K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,419 | $137K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,419 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,419 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.