| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC, | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $55K | $20K | $74K | 1.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | GLOBE LIFE AND ACCIDENT INSURANCE COMPANY | $34K | $0 | $34K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC, | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $7K | $21K | 9.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $31 | $31 | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | PROSPERITY LIFE GROUP | $4K | — | $4K | 28.47% |
| INTEGRATED WORKSITE SOLUTIONS LLC3 Filed as: INTEGRATED WORKSITE SOLUTIONS, LLC | 1758 SUNSET PRESERVE WAY PORT CHARLOTTE, FL 33953 | PROSPERITY LIFE GROUP | $328 | — | $328 | 2.34% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 16.99% |
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 | 219 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 456 | $4.2M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 456 | $3.9M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 219 | $216K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 219 | $216K |
| Short-term disability(2 contracts, 2 carriers) | GLOBE LIFE AND ACCIDENT INSURANCE COMPANY | 219 | $442K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 219 | $216K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 456 | $3.9M |
| Other(5 contracts, 5 carriers) | GLOBE LIFE AND ACCIDENT INSURANCE COMPANY | 219 | $484K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 456 | — |
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.