| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $40K | $0 | $40K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 6967 S RIVER GATE DR SUITE 200 MIDVALE, UT 84047 | ALLIED ADMINISTRATORS | $9K | $0 | $9K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 6967 S RIVER GATE DR SUITE 200 MIDVALE, UT 84047 | UNITED OF OMAHA LIFE INSURANCE CO | $5K | $0 | $5K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $2K | $2K | 4.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | $0 | $9K | 37.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $2K | $0 | $2K | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES ADMINISTRATOR | Contract Administrator Service code 13 | 736 S STONE AVE LA GRANGE, IL 60525 | $67K |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 205 | $1.3M |
| Dental | ALLIED ADMINISTRATORS | 98 | $93K |
| Vision | VISION SERVICE PLAN | 77 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE CO | 127 | $51K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE CO | 127 | $73K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 127 | $51K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE CO | 127 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.