| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $80K | $3K | $83K | 11.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF NORTH CAROLINA | $8K | — | $8K | 3.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 4.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 6.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $3K | — | $3K | 8.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 180 PARK AVE, 1ST FLOOR FLORHAM PARK, NJ 07932 | ZURICH AMERICAN INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $828 | — | $828 | 12.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $725 | — | $725 | 15.01% |
| JRW ASSOCIATES INC3 Filed as: JRW ASSOCIATES, INC. | 1616 E MILLBROOK ROAD, SUITE 250 RALEIGH, NC 27609 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 1.55% |
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 | 428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 430 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 483 | $719K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 675 | $239K |
| Vision | VISION SERVICE PLAN | 288 | $32K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 428 | $72K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 428 | $81K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 428 | $57K |
| Other(4 contracts, 3 carriers) | ZURICH AMERICAN INSURANCE COMPANY | 428 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 675 | — |
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.