| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4250 CONGRESS STREET SUITE 200 CHARLOTTE, NC 28209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $58K | $12K | $70K | 6.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4250 CONGRESS STREET SUITE 200 CHARLOTTE, NC 28208 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $177K | $9K | $186K | 20.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4064 COLONY ROAD SUITE 450 CHARLOTTE, NC 28211 | EYEMED VISION/COMBINED INSURANCE COMPANY OF AMERICA | — | $47K | $47K | 9.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4250 CONGRESS STREET SUITE 200 CHARLOTTE, NC 28209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $70K | $5K | $75K | 16.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4250 CONGRESS STREET SUITE 200 CHARLOTTE, NC 28209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $3K | $21K | 5.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4250 CONGRESS STREET SUITE 200 CHARLOTTE, NC 28209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $1K | $22K | 21.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4250 CONGRESS STREET SUITE 200 CHARLOTTE, NC 28209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $473 | $3K | 5.99% |
| 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 | $2.2M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $728K |
| DELTA DENTAL EIN 54-0844477 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $198K |
| FLORES AND ASSOCIATES EIN 56-1542307 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1218 S CHURCH ST CHARLOTTE, NC 28203 | $182K |
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 | 6,205 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 6,205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION/COMBINED INSURANCE COMPANY OF AMERICA | 7,885 | $497K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,251 | $1.2M |
| Short-term disability(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,180 | $713K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,815 | $1.2M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,243 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,885 | — |
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.