| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $7K | $7K | 10.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $2K | $2K | 10.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 ADMINISTRATOR | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $312K |
| DELTA DENTAL EIN 35-1545647 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | PO BOX 1809 ALPHARETTA, GA 30023 | $32K |
| INGENIORX, INC. EIN 82-3062245 PRESCRIPTION DRUGS ADMIN | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | 450 HEADQUARTERS PLZ MORRISTOWN, NJ 07960 | -$179K |
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 | 705 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 725 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 112 | $709K |
| Vision | EYEMED VISION CARE | 1,867 | $105K |
| Life insurance(2 contracts, 2 carriers) | LINCOLN FINANCIAL GROUP | 726 | $206K |
| Long-term disability(2 contracts, 2 carriers) | LINCOLN FINANCIAL GROUP | 726 | $85K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 726 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,867 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.