| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $70K | $0 | $70K | 6.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE COMMERCE SQUARE 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $37K | $37K | 3.35% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $214 | $214 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $7K | $2K | $9K | 1.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 SOUTH RIVERSIDE PLAZA SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | $0 | $15K | 3.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | $0 | $4K | 0.91% |
| MATTHEW W EVANS3 Filed as: MATTHEW W. EVANS | 1344 ASHTON ROAD, SUITE 200 HANOVER, MD 21076 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17K | $0 | $17K | 7.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | $0 | $10K | 4.32% |
| DREW SKIBITSKY3 Filed as: DREW SKIIBITSKY | 11285 DOVERDALE COURT MARRIOTSVILLE, MD 21104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 1.36% |
| JOHN A LECKLITER3 Filed as: JOHN ALFRED LECKLITER JR. | 2454 BARONSMEDE COURT WINTER GARDEN, FL 34787 | CONTINENTAL AMERICAN INSURANCE COMPANY | $299 | $0 | $299 | 0.13% |
| MICHELE FAYE LECKLITER3 | 2454 BARONSMEDE COURT WINTER GARDEN, FL 34787 | CONTINENTAL AMERICAN INSURANCE COMPANY | $285 | $0 | $285 | 0.12% |
| MORGAN STANLEY INS SERVICES INC3 | 2001 15TH STREET NORTH ARLINGTON, VA 22201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $273 | $0 | $273 | 0.11% |
| MJ INSURANCE3 Filed as: DALE SHADDOCK AND VARIOUS AGENTS | 8927 MAYFLOWER ROAD ROSEDALE, MD 21237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $148 | $0 | $148 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CTR, SUITE 100 RADNOR, PA 19087 | ACE AMERICAN INSURANCE COMPANY | $1K | $147 | $1K | 16.64% |
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 | 671 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 44 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 743 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 54 | $677K |
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 1,192 | $716K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 1,192 | $716K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 671 | $1.1M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 671 | $1.1M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 671 | $1.1M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 54 | $677K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 671 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,192 | — |
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.