| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | CAREFIRST BLUECHOICE, INC. | $0 | $75K | $75K | 3.32% |
| USI INSURANCE SERVICES LLC3 | 11350 MCCORMICK ROAD EXECUTIVE PLAZA 3, SUITE 1203 BALTIMORE, MD 21031 | CAREFIRST BLUECHOICE, INC. | $0 | $21K | $21K | 0.92% |
| 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 | $7K | $7K | 0.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | STANDARD INSURANCE COMPANY | $20K | $5K | $25K | 15.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3700 EMBASSY PARKWAY, SUITE 160 AKRON, OH 44333 | STANDARD INSURANCE COMPANY | $0 | $5K | $5K | 2.83% |
| USI INSURANCE SERVICES LLC3 | 222 DELAWARE AVE, SUITE 1000 WILMINGTON, DE 19801 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 2.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | UNKNOWN WASHINGTON, DC 20024 | DELTA DENTAL INSURANCE COMPANY | $5K | $0 | $5K | 3.23% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN WASHINGTON, DC 20024 | DELTA DENTAL INSURANCE COMPANY | $3K | $0 | $3K | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM INSURANCE COMPANY | $4K | $0 | $4K | 11.94% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK, SUITE 400 FALLS CHURCH, VA 22042 | UNUM INSURANCE COMPANY | $912 | $182 | $1K | 3.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $315 | $315 | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $879 | $0 | $879 | 4.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 11.56% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK, SUITE 400 FALLS CHURCH, VA 22042 | UNUM INSURANCE COMPANY OF AMERICA | $450 | $150 | $600 | 4.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY OF AMERICA | $0 | $126 | $126 | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | UNKNOWN WASHINGTON, DC 20024 | LEGAL RESOURCES | $334 | $0 | $334 | 5.14% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 283 | $2.3M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 291 | $143K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 246 | $18K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 162 | $177K |
| Short-term disability | STANDARD INSURANCE COMPANY | 162 | $164K |
| Long-term disability | STANDARD INSURANCE COMPANY | 162 | $164K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 283 | $2.3M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 162 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.