| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | MINNESOTA LIFE INSURANCE COMPANY | $66K | — | $66K | 15.00% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 5265 S TRIMBLE ROAD ATLANTA, GA 30342 | MINNESOTA LIFE INSURANCE COMPANY | — | $4K | $4K | 1.00% |
| GALLLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLLAGHER BENEFIT SERVICES INC | 4000 MIDLANTIC AVENUE SUITE 300 MT. LAUREL, NJ 08054 | AETNA LIFE INSURANCE CO. | $11K | — | $11K | 3.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $649K |
| AETNA - PPO EIN 06-6033492 NONE | Other services; Claims processing Service code 12 | — | $263K |
| MULTIPLAN EIN 43-6004435 NONE | Other services; Claims processing; Plan Administrator Service code 12 | — | $38K |
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 | 1,928 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 72 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,036 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF DELAWARE | 1,882 | $1.7M |
| Vision | VISION BENEFITS OF AMERICA | 1,747 | $160K |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 2,712 | $442K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 2,160 | $281K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 1,964 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,712 | — |
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."
No prospect flags tripped on this filing.