| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 SALT LAKE CITY, UT 84047 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $75K | $0 | $75K | 8.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 141 WEST JACKSON BOULEVARD SUITE 1000 CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $3K | $13K | 1.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $54 | $10K | 6.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $13 | $13 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 SALT LAKE CITY, UT 84047 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 9.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $788 | $788 | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVERGATE DRIVE MIDVALE, UT 84047 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 9.99% |
| UNKNOWN3 | UNKNOWN SAN JOSE, CA 95138 | TELADOC HEALTH, INC. | $1K | $0 | $1K | 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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 185 | $921K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 278 | $146K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 258 | $25K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 146 | $69K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 146 | $69K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 185 | $921K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 185 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.