| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 4064 COLONY RD SUITE 450 CHARLOTTE, NC 28211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $255K | $24K | $279K | 11.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4064 COLONY ROAD STE 450 CHARLOTTE, NC 28211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $83K | $6K | $89K | 17.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4064 COLONY ROAD SUITE 450 CHARLOTTE, NC 28211 | EYEMED VISION/COMBINED INSURANCE COMPANY OF AMERICA | $29K | — | $29K | 8.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRV | 4064 COLONY RD SUITE 450 CHARLOTTE, NC 28211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $29K | $1K | $31K | 24.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTIMA HEALTH EIN 54-1555638 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 4417 CORPORATION LANE VIRGINIA BEACH, VA 23462 | $1.4M |
| DELTA DENTAL EIN 54-0844477 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $174K |
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 | 5,532 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION/COMBINED INSURANCE COMPANY OF AMERICA | 5,792 | $331K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,700 | $2.5M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,497 | $520K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,700 | $2.5M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,983 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,792 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.