| 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. | $4K | — | $4K | 0.42% |
| 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 | $4K | — | $4K | 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 | — | $350 | $350 | 1.25% |
| 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 | — | $3K | 13.07% |
| 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 | — | $306 | $306 | 1.25% |
| 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 | $3K | — | $3K | 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 | — | $246 | $246 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 21ST FLOOR TWO PIERCE PL. ITASCA, IL 60143 | STARMOUNT LIFE INSURANCE COMPANY | $1K | — | $1K | 12.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD. 11TH FLOOR ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | — | $124 | $124 | 1.25% |
| 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 | $395 | — | $395 | 4.39% |
| 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 | $715 | — | $715 | 10.01% |
| 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 | — | $89 | $89 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES INC. EIN 36-4291971 NONE | Insurance agents and brokers Service code 22 | — | $24K |
| CUSTOM DESIGN BENEFITS EIN 81-0798821 NONE | Plan Administrator Service code 14 | — | $4K |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 228 | $937K |
| Dental | AETNA LIFE INSURANCE CO. | 228 | $937K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 89 | $10K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $7K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 74 | $28K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 74 | $52K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.