| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60006 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $13K | — | $13K | 5.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | — | $951 | $951 | 0.39% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 079811054 | METLIFE | $5K | — | $5K | 2.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 250 PARK AVENUE 3RD FLOOR NEW YORK, NY 10177 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 6.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ARTHUR J GALLAGHER CO-SUITE 300 400 MIDLAND DRIVE MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 9.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 300 MADISON AVENUE 28TH FLOOR NEW YORK, NY 10017 | GUARDIAN | $3K | — | $3K | 21.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 300 MADISON AVENUE 28TH FLOOR NEW YOR, NY 10017 | GUARDIAN | — | $310 | $310 | 2.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METLIFE LEGAL PLANS | $642 | — | $642 | 7.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | METLIFE LEGAL PLANS | $230 | — | $230 | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES OF CALIF | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 912033944 | METLIFE LEGAL PLANS | — | $115 | $115 | 1.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | METLIFE LEGAL PLANS | — | $9 | $9 | 0.11% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 1166 AVENUE OF THE AMERICAS 34TH FLOOR NEW YORK, NY 10036 | THE HARTFORD | $1K | — | $1K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $338K |
| AETNA LIFE INSURANCE EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $255K |
| AETNA BEHAVIORAL HEALTH LLC EIN 06-6033492 PLAN ADMINISTRATOR | Contract Administrator Service code 13 | — | $4K |
| PRUDENTIAL INSURANCE COMPANY OF AME EIN 22-1211670 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $240 |
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 | 320 | 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) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METLIFE | 458 | $209K |
| Vision | AETNA LIFE INSURANCE COMPANY | 213 | $22K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 427 | $153K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 427 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.