| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | FOUR RADNOR CORPORATE CENTER SUITE 500 RADNOR, PA 19087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $32K | — | $32K | 3.61% |
| BLAIR R. MOULTHROP3 | PO BOX 220 BAY CITY, MI 487070220 | BLUE CROSS / BLUE SHIELD OF MICHIGAN | $32K | — | $32K | 4.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICE, INC. EIN 41-1289245 NONE | Other services; Claims processing Service code 12 | — | $4.1M |
| ADP, INC. EIN 58-2018248 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $440K |
| ALIGHT EIN 82-1061233 NONE | Contract Administrator Service code 13 | — | $311K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Claims processing Service code 12 | — | $211K |
| BHS BEHAVIORAL HEALTH SYSTEMS SR EIN 63-1007625 NONE | Claims processing Service code 12 | — | $54K |
| EYEMED EIN 31-1339854 NONE | Claims processing Service code 12 | — | $34K |
| CAREMARK, PRESCRIPTION SERVICE DIV. EIN 95-3382344 NONE | Claims processing Service code 12 | — | $32K |
| CBIZ EIN 31-1582098 NONE | Other services Service code 49 | — | $16K |
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 | 5,346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 213 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,559 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 148 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 54 | $881K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 148 | $1.6M |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 148 | $1.6M |
| Other | UNITED BEHAVIORAL HEALTH | 12,634 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,634 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.