| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | $96K | $0 | $96K | 2.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | ANTHEM BLUE CROSS | $41K | $0 | $41K | 9.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | STANDARD INSURANCE COMPANY | $27K | $6K | $33K | 12.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE SUITE 410 CLEVELAND, OH 44113 | ANTHEM BLUE CROSS | $2K | $256 | $3K | 7.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 23-7391136 NONE | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $60K |
| GALLAGHER BENEFIT SERVICES INC | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $9K |
| EMPIRE HEALTHCOICE ASSURANCE, INC EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Contract Administrator Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $0 |
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 | 316 | 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) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | 569 | $4.1M |
| Dental | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | 569 | $4.1M |
| Vision | ANTHEM BLUE CROSS | 447 | $34K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 566 | $688K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 566 | $688K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 566 | $688K |
| Prescription drug | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | 569 | $4.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 569 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.