| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 600084036 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $622 | $7K | 4.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 15 W SOUTH TEMPLE SUITE 700 SALT LAKE CITY, UT 841011533 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 2.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | — | $839 | $839 | 1.38% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $153 | $153 | 0.25% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 320 | $150K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 320 | $150K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 202 | $61K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 202 | $61K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 202 | $61K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 320 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.