| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $215K | $10K | $225K | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $74K | $0 | $74K | 11.49% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 2.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $6K | $6K | 0.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5205 MARYLAND WAY, SUITE 300 BRENTWOOD, TN 37027 | DELTA DENTAL OF TENNESSEE | $43K | $0 | $43K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $12K | $0 | $12K | 9.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | METLIFE LEGAL PLANS | $1K | $204 | $2K | 11.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $630 | $0 | $630 | 10.01% |
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 | 911 | 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) | 911 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,710 | $7.5M |
| Dental | DELTA DENTAL OF TENNESSEE | 1,873 | $533K |
| Vision | VISION SERVICE PLAN | 796 | $131K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,325 | $642K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,325 | $642K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,325 | $642K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,710 | $7.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,325 | $657K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,873 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.