| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 201 EAST 4TH STREET SUITE 625 CINCINNATI, OH 45202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $38K | — | $38K | 7.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD 5TH FL ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20K | — | $20K | 3.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $54 | $21K | 9.99% |
| LIAZON BENEFITS INC5 | 199 SCOTT ST., FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $10K | $10K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7 | $7 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD., FL 11RE ROLLING MEADOWS, IL 600084050 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $2K | $8K | 13.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $54 | $8K | 15.98% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOTT ST. FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $732 | $732 | 1.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $54 | $5K | 15.63% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOT ST. FL 8 BUFFALO, NY 142022265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $453 | $453 | 1.47% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION - EXCHANGE | 199 SCOTT ST., 8TH FL BUFFALO, NY 14204 | FIDELITY SECURITY LIFE INSURANCE COMPANY | -$280 | — | -$280 | -1.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | CINCI, OH 2850 GOLF RD. ROLLING MEADOWS, IL 60008 | FIDELITY SECURITY LIFE INSURANCE COMPANY | -$564 | — | -$564 | -2.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Other services Service code 12 | — | $140K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 NONE | Other commissions Service code 55 | — | $24K |
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 | 205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 127 | $79K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 258 | $209K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 353 | $26K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 258 | $209K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 215 | $59K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 209 | $525K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 258 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.