| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE ROWLEY AGENCY3 | PO BOX 511 CONCORD, IL 03302 | SUN LIFE ASSURANCE COMPANY OF CANADA | $49K | $0 | $49K | 0.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | $0 | $18K | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | STARMOUNT LIFE INSURANCE COMPANY | $6K | $504 | $6K | 3.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $206 | $206 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $336 | $9K | 9.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $134 | $134 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $336 | $9K | 9.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $134 | $134 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $1K | $6K | 16.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $43 | $43 | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 511 CONCORD, NH 03302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $515 | $0 | $515 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS INC EIN 04-2734278 ADMINISTRATOR | Claims processing; Other services Service code 12 | 1500 WEST PARK DR WESTBOROUGH, MA 01581 | $61K |
| THE ROWLEY AGENCY BROKER | Claims processing Service code 12 | PO BOX 511 CONCORD, NH 03302 | $49K |
| GALLAGHER BENEFIT SERVICES ADMINISTRATOR | Contract Administrator Service code 13 | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | $41K |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $5K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 107 | $161K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 107 | $161K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 132 | $195K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 132 | $195K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 132 | $195K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 105 | $7.3M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 132 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.