| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 545 METRO PLACE SOUTH, SUITE 150 DUBLIN, OH 43017 | CAREFIRST BLUECHOICE, INC. | $0 | $69K | $69K | 3.04% |
| MATHER & STROHL ADMIN SVC INC5 Filed as: MATHER AND STROHL ADMIN. SERVICES | 12404 PARK CENTRAL DRIVE, SUITE 400 DALLAS, TX 75251 | CAREFIRST BLUECHOICE, INC. | $0 | $11K | $11K | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | STANDARD INSURANCE COMPANY | $23K | $0 | $23K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $0 | $5K | $5K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | DELTA DENTAL INSURANCE COMPANY | $7K | $0 | $7K | 5.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $494 | $0 | $494 | 4.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY | $0 | $245 | $245 | 2.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | LEGAL RESOURCES | $420 | $0 | $420 | 5.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $227 | $0 | $227 | 15.00% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 272 | $2.3M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 256 | $124K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 217 | $11K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 125 | $166K |
| Short-term disability | STANDARD INSURANCE COMPANY | 125 | $156K |
| Long-term disability | STANDARD INSURANCE COMPANY | 125 | $156K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 272 | $2.3M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 125 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.