| 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 | $251K | $38K | $289K | 10.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4064 COLONY ROAD STE 450 CHARLOTTE, NC 28211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $75K | $8K | $83K | 16.54% |
| 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 | $24K | — | $24K | 6.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRV | 4064 COLONY RD SUITE 450 CHARLOTTE, NC 28211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $2K | $22K | 16.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INNOVATION HEALTH INSURANCE COMPANY EIN 46-0674828 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 3190 FAIRVIEW PARK DRIVE FALLS CHURCH, VA 22042 | $1.4M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $535K |
| DELTA DENTAL EIN 54-0844477 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $162K |
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 | 5,603 | 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 | 6,374 | $356K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,050 | $2.7M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,578 | $502K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,050 | $2.7M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,050 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,374 | — |
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.