| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR SUITE 200 BROOKFIELD, WI 48801 | UNITEDHEALTHCARE INSURANCE COMPANY | -$3 | $45K | $45K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FLOOR 4 ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $253 | $253 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $2K | $8K | 11.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $7K | $0 | $7K | 11.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 245 S EXECUTIVE DR STE 200 BROOKFIELD, WI 53005 | WYSSTA INSURANCE COMPANY INC | $1K | $0 | $1K | 11.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $294 | $1K | 18.83% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 311 | $1.5M |
| Dental | DELTA DENTAL OF WISCONSIN | 113 | $65K |
| Vision | WYSSTA INSURANCE COMPANY INC | 102 | $11K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 199 | $76K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 199 | $76K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 199 | $76K |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 199 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.