| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 545 METRO PLACE SOUTH SUITE 150 DUBLIN, OH 43017 | CAREFIRST BLUECHOICE, INC. | -$1 | $57K | $57K | 3.50% |
| MATHER & STROHL ADMIN SVC INC3 Filed as: MATHER & STROHL ADMINISTRATIVE SERV | 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | CAREFIRST BLUECHOICE, INC. | — | $9K | $9K | 0.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $3K | $8K | 7.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | — | DELTA DENTAL INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - ROCKVI | 15800 CRABBS BRANCH WAY #350 ROCKVILLE, MD 20855 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $451 | — | $451 | 3.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRCH WAY SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $997 | — | $997 | 15.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $19 | $19 | 0.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT | — | LEGAL RESOURCES | $342 | — | $342 | 5.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, IN | 15800 CRABBS BRCH WAY SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $934 | — | $934 | 16.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 1.38% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 158 | $1.6M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 160 | $109K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 274 | $13K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 170 | $116K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 170 | $110K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 170 | $110K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 158 | $1.6M |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 170 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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.