| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 111 VETERANS BLVD SUITE 1130 METAIRIE, LA 70005 | AETNA LIFE INSURANCE CO. | $145K | — | $145K | 3.00% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $121K | — | $121K | 2.50% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 5.00% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 5.00% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 5.00% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $322 | $0 | $322 | 5.00% |
| EDWARD BASSO3 | 71146 RIVERSIDE DRIVE COVINGTON, LA 70043 | EYEMED | $3K | — | $3K | — |
| EDWARD BASSO3 | 71146 RIVERSIDE DRIVE COVINGTON, LA 70043 | EYEMED | $32 | — | $32 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $5K |
| AUSTIN CAPITAL PLAN ADM SERVICES FSA CLAIMS ADMIN | Claims processing Service code 12 | 1601 ELM STREET SUITE 4310 DALLAS, TX 75201 | $0 |
| GALLAGHER BENEFIT SERVICES, INC. INSURANCE AGENT/BROKER | Insurance services Service code 23 | 111 VETERANS BLVD SUITE 1130 METAIRIE, LA 700053039 | $0 |
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 | 411 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 411 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 827 | $4.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 312 | $247K |
| Vision(2 contracts) | EYEMED | 603 | $0 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 406 | $74K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 406 | $63K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 406 | $98K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 406 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 827 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.