| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVE. E. #1700 CLEVELAND, OH 44114 | HEALTHSPAN INTEGRATED CARE | $20K | $0 | $20K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1100 SUPERIOR AVE. SUITE 1700 CLEVELAND, OH 44114 | MEDICAL MUTUAL OF OHIO | $6K | $3K | $10K | 4.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | LINCOLN NATIONAL LIFE INSURANCE CO. | $6K | $0 | $6K | 5.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | LINCOLN NATIONAL LIFE INSURANCE CO. | $0 | $2K | $2K | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 6.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | LINCOLN NATIONAL LIFE INSURANCE CO. | $3K | $0 | $3K | 6.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | LINCOLN NATIONAL LIFE INSURANCE CO. | $0 | $710 | $710 | 1.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | LINCOLN NATIONAL LIFE INSURANCE CO. | $8K | $0 | $8K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | LINCOLN NATIONAL LIFE INSURANCE CO. | $0 | $582 | $582 | 1.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PLACE FL 14 ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $721 | $721 | 1.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | LINCOLN NATIONAL LIFE INSURANCE CO. | $5K | $0 | $5K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | LINCOLN NATIONAL LIFE INSURANCE CO. | $0 | $353 | $353 | 1.42% |
| RONALD B. BIXEL3 | 8561 EAST AVENUE MENTOR, OH 44060 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $359 | $0 | $359 | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8561 EAST AVENUE MENTOR, OH 44060 | LINCOLN NATIONAL LIFE INSURANCE CO. | $789 | $0 | $789 | 20.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | LINCOLN NATIONAL LIFE INSURANCE CO. | $0 | $58 | $58 | 1.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 8052 WAUSAU, WI 54402 | $169K |
| GALLAGHER BENEFIT SERVICES INC. EIN 36-4291971 BROKER | Other commissions Service code 55 | #310, 50 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | $19K |
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 | 451 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHSPAN INTEGRATED CARE | 83 | $1.2M |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 295 | $58K |
| Life insurance(3 contracts) | LINCOLN NATIONAL LIFE INSURANCE CO. | 451 | $92K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE CO. | 188 | $102K |
| Long-term disability(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 237 | $101K |
| Prescription drug(2 contracts, 2 carriers) | HEALTHSPAN INTEGRATED CARE | 83 | $1.2M |
| Other(5 contracts, 3 carriers) | LINCOLN NATIONAL LIFE INSURANCE CO. | 521 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 521 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.