| 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 | $58K | $106K | $164K | 2.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $215K | $19K | $234K | 26.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2056 VISTA PARKWAY, SUITE 300 WEST PALM BEACH, FL 33411 | BLUE CROSS BLUE SHIELD OF FLORIDA | $9K | $0 | $9K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $6K | $0 | $6K | 7.40% |
| ENERGY INSURANCE AGENCY INC4 Filed as: ENERGY INSURANCE AGENCY | 3008 ATKINSON AVENUE LEXINGTON, KY 40509 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 3.25% |
| ALAN ROMAN4 | 7220 PRINCETON AVENUE SAINT LOUIS, MO 63130 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $21 | $0 | $21 | 0.03% |
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 | 635 | 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) | 635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,303 | $8.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,303 | $7.8M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,303 | $7.8M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 615 | $873K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 615 | $873K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 615 | $873K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,303 | $8.1M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 615 | $948K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,303 | — |
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.