| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203417 DALLAS, TX 75320 | COMMUNITY INSURANCE COMPANY | $45K | $4K | $49K | 0.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1301 EAST 9TH STREET, SUITE 3800 CLEVELAND, OH 44114 | COMMUNITY INSURANCE COMPANY | $5K | — | $5K | 0.08% |
| LTC CHOICES3 | 1291 STEAMBOAT SPRINGS COURT BLACKLICK, OH 43004 | JOHN HANCOCK | $7K | — | $7K | 4.40% |
| LTCI PARTNERS LLC3 Filed as: LTCI PARTNERS, LLC | 2924 MARKETPLACE, SUITE 102 MADISON, WI 53719 | JOHN HANCOCK | $5K | — | $5K | 3.56% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 28260 | JOHN HANCOCK | $3K | — | $3K | 1.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203373 DALLAS, TX 75320 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 5.17% |
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 | 556 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 592 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 452 | $6.3M |
| Vision | VISION SERVICE PLAN | 296 | $34K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 556 | $120K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 452 | $6.3M |
| Other(3 contracts, 3 carriers) | JOHN HANCOCK | 556 | $269K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 556 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.