| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | BLUECROSS BLUESHIELD OF ILLINOIS | $336K | $12K | $348K | 4.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8800 EAST RAINTREE DRIVE, SUITE 250 SCOTTSDALE, AZ 85260 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $15K | $30K | 7.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | STANDARD INSURANCE COMPANY | $1K | $589 | $2K | 1.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $403 | $0 | $403 | 0.53% |
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 | 1,090 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 1,444 | $8.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 838 | $415K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 849 | $76K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,085 | $92K |
| Short-term disability | STANDARD INSURANCE COMPANY | 1,085 | $92K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,085 | $92K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 1,444 | $8.5M |
| Other | STANDARD INSURANCE COMPANY | 1,085 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,444 | — |
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.