| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | QCA HEALTH PLAN | $57K | $0 | $57K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DELTA DENTAL OF ARKANSAS | $11K | $0 | $11K | 10.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | UNICARE LIFE AND HEALTH INSURANCE COMPANY | $8K | $828 | $9K | 9.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $25K | $0 | $25K | 28.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 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 | 424 | 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) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QCA HEALTH PLAN | 286 | $2.3M |
| Dental | DELTA DENTAL OF ARKANSAS | 390 | $103K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 310 | $31K |
| Life insurance | UNICARE LIFE AND HEALTH INSURANCE COMPANY | 424 | $88K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 476 | $86K |
| Prescription drug | QCA HEALTH PLAN | 286 | $2.3M |
| Other(2 contracts, 2 carriers) | UNICARE LIFE AND HEALTH INSURANCE COMPANY | 476 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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.