| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 141 WEST JACKSON BOULEVARD SUITE 1000 CHICAGO, IL 60604 | PREMERA BLUE CROSS | $182K | $0 | $182K | 4.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PREMERA BLUE CROSS | $0 | $53K | $53K | 1.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $23K | $1K | $25K | 14.64% |
| CONNEXION INSURANCE SOLUTIONS3 | 7001 220TH SW, MAIL STOP 320 MOUNTLAKE TERRACE, WA 98043 | HARTFORD LIFE AND ACCIDENT | $0 | $11K | $11K | 6.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 17.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $178 | $178 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, WA 60694 | VISION SERVICE PLAN | $743 | $0 | $743 | 5.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $598 | $0 | $598 | 4.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | STANDARD INSURANCE COMPANY | $2K | $145 | $2K | 19.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $0 | $283 | $283 | 2.39% |
| UNKNOWN3 | UNKNOWN MERCER ISLAND, WA 98040 | FIRST CHOICE | $461 | $0 | $461 | 11.04% |
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 | 262 | 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) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 287 | $4.3M |
| Dental | PREMERA BLUE CROSS | 287 | $4.3M |
| Vision | VISION SERVICE PLAN | 84 | $13K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 185 | $184K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 185 | $170K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 185 | $170K |
| Prescription drug | PREMERA BLUE CROSS | 287 | $4.3M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 185 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.