| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $121K | $0 | $121K | 10.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE COMMERCE SQUARE 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 1.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF KENTUCKY | $21K | $0 | $21K | 2.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | BANKERS FIDELITY LIFE INSURANCE COMPANY | $8K | $0 | $8K | 13.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 800 MARKET STREET, SUTIE 1800 SAINT LOUIS, MO 63101 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $6K | $0 | $6K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 10.00% |
| CROUSE COMPANY LLC4 | 818A DELMAS AVENUE NASHVILLE, TN 37216 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $978 | — | $978 | 6.00% |
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 | 1,256 | 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) | 1,256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 1,774 | $709K |
| Vision | DELTA DENTAL OF KENTUCKY | 1,774 | $709K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,256 | $1.2M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,256 | $1.2M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,256 | $1.2M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,256 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,774 | — |
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.