| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1111 SUPERIOR AVE. E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $41 | $16K | 10.13% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS INC. | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $8K | $8K | 4.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE. E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | — | $20 | $20 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | 1111 SUPERIOR AVE STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $43 | $3K | — |
| LIAZON BENEFITS INC Filed as: LIAZON BENEFITS INC. | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $919 | $919 | — |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $277 | $277 | — |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $44 | $3K | — |
| LIAZON BENEFITS INC | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | — |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $325 | $325 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY (G1728) EIN 31-1440175 | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Other services Service code 12 | — | $106K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 | Other commissions; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| INGENIORX, INC. EIN 82-3062245 | Float revenue; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | -$33K |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 146 | $264K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $160K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $160K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $160K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $160K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $160K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 129 | $264K |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.