| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $275K | $0 | $275K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $126 | $126 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48K | $0 | $48K | 58.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2121 NORTH CALIFORNIA BOULEVARD SUITE 350 WALNUT CREEK, CA 94596 | CONCERN EAP | $2K | $0 | $2K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METLIFE LEGAL PLANS | $1K | $0 | $1K | 7.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | METLIFE LEGAL PLANS | $350 | $0 | $350 | 2.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | METLIFE LEGAL PLANS | $0 | $90 | $90 | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2121 NORTH CALIFORNIA BOULEVARD SUITE 350 WALNUT CREEK, CA 94596 | COMBINED INSURANCE | $8K | $0 | $8K | 88.19% |
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 | 2,067 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,069 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,158 | $7.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,303 | $553K |
| Vision | VISION SERVICE PLAN | 590 | $72K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 813 | $219K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 813 | $219K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,158 | $7.0M |
| Other(6 contracts, 6 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,664 | $357K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,664 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.