| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1160 NORTH TOWN CENTER DRIVE SUITE 300 LAS VEGAS, NV 89144 | DELTA DENTAL OF CALIFORNIA | $28K | $0 | $28K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 COMMERCE SQUARE, SUITE 820 PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 1.29% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $248 | $248 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $32K | $0 | $32K | 22.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METLIFE LEGAL PLANS | $2K | $106 | $2K | 10.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 181 EAST 5600 SOUTH, SUITE 240 SALT LAKE CITY, UT 84107 | METLIFE LEGAL PLANS | $0 | $486 | $486 | 2.58% |
| BUSINESSSOLVER.COM, INC.3 | 1025 ASHWORTH ROAD WEST DES MOINES, IA 50265 | METLIFE LEGAL PLANS | $0 | $152 | $152 | 0.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN GENERAL INSURANCE COMPANY | $882 | $106 | $988 | 11.07% |
| BUSINESSOLVER.COM, INC.3 | 1025 ASHWORTH ROAD WEST DES MOINES, IA 50265 | METROPOLITAN GENERAL INSURANCE COMPANY | $0 | $269 | $269 | 3.01% |
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 | 755 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 755 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 2,013 | $920K |
| Vision | VISION SERVICE PLAN | 733 | $129K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 874 | $797K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 874 | $797K |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,793 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,793 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.