| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVS USA IL | 2107 S NEIL ST CHAMPAIGN, IL 61820 | HEALTH ALLIANCE MEDICAL PLANS | $30K | — | $30K | 1.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 2502 N ROCKY POINT DR STE 400 TAMPA, FL 336071443 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 3.17% |
| BARHAM BENEFIT GROUP3 | 919 W KIRBY AVE CHAMPAIGN, IL 618215121 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10 S WACKER DRIVE FL 17 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $917 | $917 | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 2502 N ROCKY POINT DR STE 400 TAMPA, FL 336071443 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 8.75% |
| BARHAM BENEFIT GROUP3 | 919 W KIRBY AVE CHAMPAIGN, IL 618215121 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVSC USA INC | 10 S WACKER DR FL 17 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $424 | $424 | 1.02% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203991 DALLAS, TX 753203991 | VISION SERVICE PLAN | $614 | — | $614 | 4.90% |
| BARHAM BENEFIT GROUP3 | 919 W KIRBY AVE CHAMPAIGN, IL 618215121 | VISION SERVICE PLAN | $226 | — | $226 | 1.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS PLANNING CONSULTANTS INC EIN 36-3036100 THIRD PARTY ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Direct payment from the plan Service code 12 | 2110 CLEARLAKE BLVD SUITE 200 CHAMPAIGN, IL 618267500 | $6K |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 183 | $1.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 295 | $92K |
| Vision | VISION SERVICE PLAN | 115 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 241 | $42K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLANS | 183 | $1.7M |
| Other | HEALTH ALLIANCE MEDICAL PLANS | 183 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.