| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | ANTHEM INSURANCES COMPANIES, INC. | $27K | $506 | $28K | 2.85% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | ANTHEM INSURANCES COMPANIES, INC. | $15K | — | $15K | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $23 | $2K | 13.05% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMENT DRIVE URBANDALE, IA 503232317 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $991 | — | $991 | 7.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 E CARMEL DRIVE SUITE 400 SUITE 400 INDIANAPOLIS, IN 46202 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.14% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMENT DRIVE URBANDALE, IA 503232317 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $745 | $0 | $745 | 5.87% |
| GREGORY & APPEL, INC.3 | 1402 NORTH CAPITOL AVENUE SUITE 400 INDIANAPOLIS, IN 46202 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $480 | — | $480 | 7.03% |
| AHA FINANCIAL SOLUTIONS, INC.3 | 155 NORTH WACKER DRIVE, SUITE 400 CHICAGO, IL 60606 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $12 | — | $12 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $512 | $6 | $518 | 12.51% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMENT DRIVE URBANDALE, IA 503232317 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $316 | — | $316 | 7.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 E CARMEL DRIVE SUITE 400 SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $673 | $5 | $678 | 22.11% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMENT DRIVE URBANDALE, IA 503232317 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $247 | — | $247 | 8.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $442 | $4 | $446 | 17.88% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMENT DRIVE URBANDALE, IA 503232317 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $306 | — | $306 | 12.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $187 | $2 | $189 | 28.77% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMENT DRIVE URBANDALE, IA 503232317 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10 | — | $10 | 1.52% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCES COMPANIES, INC. | 182 | $969K |
| Dental | ANTHEM INSURANCES COMPANIES, INC. | 182 | $969K |
| Vision | ANTHEM INSURANCES COMPANIES, INC. | 182 | $969K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 901 | $20K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 18 | $14K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 14 | $4K |
| Prescription drug | ANTHEM INSURANCES COMPANIES, INC. | 182 | $969K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 901 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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.