| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 201 E. 4TH ST. CINCINNATI, OH 45202 | AETNA LIFE INSURANCE CO. | $0 | $3K | $3K | 0.33% |
| BRIAN WHITE3 Filed as: BRIAN KEMPTON | 2850 GOLD ROAD ROLLING MEADOWS, IL 60008 | BLUE CARE NETWORK | $17K | — | $17K | 4.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 21ST FLOOR TWO PIERCE PL. ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD. 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $494 | $494 | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 11.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLD RD. 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $334 | $334 | 1.25% |
| BRIAN WHITE3 Filed as: BRIAN KEMPTON | 2850 GOLD ROAD ROLLING MEADOWS, IL 60008 | BLUE CROSS BLUE SHIELD | $1K | — | $1K | 4.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD. 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $390 | $4K | 16.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 21ST FL TWO PIERCE PL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 28.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD. 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $330 | $330 | 2.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD. ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $177 | $2K | 13.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $772 | $123 | $895 | 11.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 NONE | Insurance agents and brokers Service code 22 | — | $1K |
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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 247 | $839K |
| Dental | AETNA LIFE INSURANCE CO. | 247 | $839K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 98 | $11K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 172 | $33K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 93 | $46K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 81 | $58K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK | 63 | $395K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 172 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.