| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201629 DALLAS, TX 75320 | HUMANA MEDICAL PLAN, INC. | $39K | $3K | $41K | 1.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203383 DALLAS, TX 75320 | SUN LIFE ASSURANCE COMPANY OF CANADA | $21K | — | $21K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $2K | $16K | 11.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA, INC. | 806 TYVOLA ROAD, SUITE 108 CHARLOTTE, NC 28290 | METROPOLITAN LIFE INSURANCE COMPANY | — | $42 | $42 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $4K | $653 | $4K | 11.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | ONE NORTH JEFFERSON, BUILDING C-3 SAINT LOUIS, MO 63103 | ADVANTICA REINSURANCE COMPANY | $4K | — | $4K | 12.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 2502 NORTH ROCKY POINT, SUITE 400 TAMPA, FL 33607 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
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 | 462 | 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) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA MEDICAL PLAN, INC. | 462 | $3.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 455 | $172K |
| Vision | ADVANTICA REINSURANCE COMPANY | 509 | $33K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 875 | $212K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 875 | $212K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 875 | $212K |
| Prescription drug | HUMANA MEDICAL PLAN, INC. | 462 | $3.9M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 875 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 875 | — |
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.