| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | BLUECROSS BLUESHIELD OF ILLINOIS | $109K | $4K | $112K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $64 | $5K | 2.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 1.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 6.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $106 | — | $106 | 0.06% |
| AXA ASSISTANCE, USA3 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $93 | $93 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BEENFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | EYEMED | $2K | — | $2K | 9.16% |
| EUGENE TKALITCH & ASSOCIATES LTD3 Filed as: EUGENE TKALITCH AND ASSOCIATES LTD | 6601 NORTH AVONDALE AVENUE CHICAGO, IL 60659 | FEDERAL INSURANCE COMPANY | $315 | — | $315 | 15.00% |
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 | 261 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 114 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 412 | $3.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 644 | $219K |
| Vision | EYEMED | 436 | $26K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $176K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $176K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $176K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 644 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.