| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1847 W JEFFERSON AVE NAPERVILLE, IL 60540 | HEALTH CARE SERVICE CORPORATION | $63K | — | $63K | 3.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | HEALTH CARE SERVICE CORPORATION | — | $2K | $2K | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 8.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $554 | $7K | 16.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1847 W JEFFERSON AVE NAPERVILLE, IL 60540 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 67.00% |
| THE PIETSCH FINANCIAL GROUP3 Filed as: THE PIETSCH FINANCIAL GROUP INC | 1751 LAKE COOK ROAD SUITE 350 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $47 | — | $47 | 0.20% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 525 W MONROE SUITE 600 CHICAGO, IL 60661 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES | 525 W MONROE SUITE 600 CHICAGO, IL 60661 | LIBERTY INSURANCE COMPANY | $375 | — | $375 | 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 | 101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 222 | $1.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 97 | $24K |
| Vision | VISION SERVICE PLAN | 97 | $15K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $149K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $105K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.