| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH, 8TH FLOOR SAINT LOUIS PARK, MN 55426 | HIGHMARK DELAWARE | $33K | — | $33K | 2.79% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS DOWNES | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | HIGHMARK DELAWARE | $6K | — | $6K | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 2030 MAIN STREET, SUITE 700 IRVINE, CA 92614 | AETNA LIFE INSURANCE COMPANY | — | $91 | $91 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $7K | 10.43% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS DOWNES | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.22% |
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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK DELAWARE | 155 | $1.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 197 | $72K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 102 | $69K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 102 | $69K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 102 | $69K |
| Prescription drug | HIGHMARK DELAWARE | 155 | $1.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 102 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.