| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4 RADNOR CORP CENTER SUITE 510 RADNOR, PA 19087 | MINNESOTA LIFE INSURANCE COMPANY | $33K | $0 | $33K | 8.88% |
| PSA FINANCIAL, INC.3 Filed as: PSA FINANCIAL INC | 11311 MCCORMICK RD 5TH FLOOR HUNT VALLEY, MD 21031 | MINNESOTA LIFE INSURANCE COMPANY | $23K | $0 | $23K | 6.12% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | MINNESOTA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2081 VISTA PARKWAY SUITE 300 WEST PALM BEACH, FL 33411 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 2.69% |
| BENEFITS ADVISORS SERVICES GROUP3 Filed as: BENEFITS ADVISORS SERVICES GRP | 1120 SANCTUARY PARKWAY SUITE 375 ALPHARETTA, GA 30009 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 1.33% |
| PSA FINANCIAL, INC.3 Filed as: PSA INSURANCE INC | 11311 MCCORMICK ROAD HUNT VALLEY, MD 210318622 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 1.30% |
| HOME OFFICE TPA PAYS COMMISSION3 Filed as: HOME OFFICE DIRECT | ONE HARTFORD PLAZA HARTFORD, CT 06155 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $593K |
| AETNA - PPO EIN 06-6033492 NONE | Other services; Claims processing Service code 12 | — | $236K |
| MULTIPLAN EIN 43-6004435 NONE | Other services; Claims processing; Plan Administrator Service code 12 | — | $49K |
| ACS - A XEROX COMPANY EIN 36-4129784 NONE | Other services; Claims processing Service code 12 | — | $11K |
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 | 1,734 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 45 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,821 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF DELAWARE | 1,778 | $1.5M |
| Vision | VISION BENEFITS OF AMERICA | 1,625 | $145K |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 2,463 | $371K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,028 | $291K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 1,856 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,463 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.