| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE, SUITE #1601 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 11.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVENUE E, SUITE #1601 CLEVELAND, OH 44114 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | GUARDIAN | $5K | $1K | $6K | 25.11% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | COMMUNITY INSURANCE CO DBA ANTHEM BLUE CROSS & BLUE SHIELD | — | $3K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 | Other services; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $208K |
| GALLAGHER BENEFIT SERVICES INC EIN 31-1440175 | Insurance agents and brokers; Insurance brokerage commissions and fees; Other fees; Other commissions Service code 22 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | $0 |
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 | 363 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 366 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 361 | $24K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 623 | $37K |
| Life insurance | GUARDIAN | 361 | $24K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $38K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 361 | $62K |
| Other | GUARDIAN | 361 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.