| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $85K | $2K | $86K | 79.72% |
| SHAWAN MARQUIS AGENCY INC3 | 110 EAST WILSON BRIDGE RD STE 260 COLUMBUS, OH 43085 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $901 | $580 | $1K | 1.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $2K | — | $2K | 9.89% |
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 | 176 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY (G1728) | 374 | $2.8M |
| Dental | COMMUNITY INSURANCE COMPANY (G1728) | 374 | $2.8M |
| Vision | VISION SERVICE PLAN | 157 | $22K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY (G1400) | 146 | $108K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY (G1400) | 146 | $108K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY (G1400) | 146 | $108K |
| Other | ANTHEM LIFE INSURANCE COMPANY (G1400) | 146 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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.