| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | UNITEDHEALTHCARE INSURANCE COMPANY | $88K | $172K | $260K | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $50K | $50K | 0.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $18K | $18K | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $205K | $0 | $205K | 17.70% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY INC. | PO BOX 55268 LEXINGTON, KY 40555 | HARTFORD LIFE AND ACCIDENT | $0 | $166 | $166 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2056 VISTA PARKWAY, SUITE 300 WEST PALM BEACH, FL 33411 | BLUE CROSS BLUE SHIELD OF FLORIDA | $8K | $0 | $8K | 2.50% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY | 3008 ATKINSON AVENUE LEXINGTON, KY 40509 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $14K | $0 | $14K | 11.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $967 | $0 | $967 | 0.80% |
| SYNERGY BENEFIT AND RISK MGMT INC.3 | 300 CAHABA PARK CIRCLE, SUITE 133 BIRMINGHAM, AL 35242 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $23 | $0 | $23 | 0.02% |
| BETTY ANN SIMS3 | PO BOX 870 ELIZABETH, CO 80107 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $22 | $0 | $22 | 0.02% |
| SCHLEIBAUM AND ASSOCIATES3 | 9035 WADSWORTH, SUITE 3850 WESTMINSTER, CO 80021 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $1K | $0 | $1K | 3.41% |
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 | 1,056 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,060 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,136 | $12.4M |
| Dental(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,136 | $12.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 2,136 | $12.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 962 | $1.2M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 962 | $1.2M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 962 | $1.2M |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,136 | $12.4M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 962 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,136 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.