| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | COMMUNITY INSURANCE COMPANY | $34K | $2K | $36K | 1.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $18K | $4K | $22K | 14.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $5K | — | $5K | 4.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $336 | $2K | 11.93% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $853 | $75 | $928 | 5.43% |
| DIGITAL INSURANCE LLC4 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $449 | $0 | $449 | 11.93% |
| JAN TINDER ENTERPRISES INC4 | 6943 COHASSET CIRCLE RIVERVIEW, FL 33578 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $79 | — | $79 | 2.10% |
| GALLAGHER BENEFIT SERVICES, INC.4 | PO BOX 95287 CHICAGO, IL 60694 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $36 | — | $36 | 0.96% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 268 | $2.5M |
| Dental | DELTA DENTAL OF OHIO | 319 | $117K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $17K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 187 | $156K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 187 | $156K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 187 | $156K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 268 | $2.5M |
| Other(3 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 187 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.