| 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 | $102K | $4K | $106K | 2.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | SUN LIFE ASSURANCE COMPANY OF CANADA | $16K | — | $16K | 3.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $16K | $16K | 3.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | — | $15K | 5.08% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 1.08% |
| GROUP MARKETING SERVICES INC3 Filed as: GROUP MARKETING SERVICES, INC. | PO BOX 19040 KALAMAZOO, MI 49019 | ASSURITY LIFE INSURANCE COMPANY | $7K | $252 | $7K | 5.19% |
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 | 442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 711 | $4.6M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 422 | $503K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 88 | $298K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 422 | $634K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 422 | $503K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 422 | $503K |
| Prescription drug | ASSURITY LIFE INSURANCE COMPANY | 12 | $131K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 88 | $298K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 422 | $503K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 711 | — |
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.