| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $100K | $15K | $115K | 12.57% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INS. GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $50K | $50K | 5.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $26K | $108 | $26K | 12.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $551 | $0 | $551 | 0.27% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $227 | $227 | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $418 | $0 | $418 | 10.00% |
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 | 1,310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 36 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $4K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,310 | $1.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,310 | $1.2M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,548 | $913K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,548 | $913K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,548 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,548 | — |
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.