| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $3K | $0 | $3K | 3.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GSA NATIONAL EIN 45-2712335 TPA | Claims processing Service code 12 | — | $156K |
| AJ GALLAGHER EIN 36-4291971 BROKER | Claims processing Service code 12 | — | $132K |
| EMPLOYER DIRECT HEALTHCARE SURGERY EIN 45-3780484 MEDICAL | Claims processing Service code 12 | — | $96K |
| TRIA HEALTH EIN 27-1515235 TELEHEALTH | Other services Service code 49 | — | $40K |
| BDO USA LLP EIN 13-5381590 AUDIT | Accounting (including auditing) Service code 10 | — | $28K |
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 | 1,353 | 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) | 1,353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 945 | $92K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,353 | $212K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,353 | $187K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,353 | $187K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TEXAS | 1,353 | $10.6M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,353 | $212K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,353 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.