| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 753203066 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $57 | $2K | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST NINTH AVENUE KING OF PRUSSIA, PA 194061225 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $597 | $597 | 0.11% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $895 | $322 | $1K | 5.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1750 H STREET NORTHWEST SUITE 200 WASHINGTON, DC 20006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $300 | $0 | $300 | 1.26% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $121 | $0 | $121 | 3.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1750 H STREET NORTHWEST SUITE 200 WASHINGTON, DC 20006 | FIRST UNUM LIFE INSURANCE COMPANY | $40 | $0 | $40 | 1.25% |
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 | 494 | 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) | 494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,160 | $540K |
| Vision | NATIONAL VISION (NVA) | 927 | $46K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 9 | $3K |
| Other | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 77 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,160 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.