| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | 2850 W. GOLF ROAD ROLLING MEADOWS, IL 60005 | OPTUM HEALTH FINANCIAL SERVICES | $10K | — | $10K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL | $2K | — | $2K | 3.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6325 RANCH ROAD LITTLE ROCK, AR 72223 | TRUSTMARK INSURANCE COMPANY | $3K | — | $3K | 8.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL | $2K | — | $2K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6325 RANCH ROAD LITTLE ROCK, AR 72223 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 10.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6325 RANCH ROAD LITTLE ROCK, AR 72223 | TRUSTMARK INSURANCE COMPANY | $720 | — | $720 | 7.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11219 FINANCIAL CENTRE PKWY, #311 LITTLE ROCK, AR 72211 | GUARDIAN LIFE INSURANCE COMPANY | $911 | — | $911 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11219 FINANCIAL CENTRE PKWY, #311 LITTLE ROCK, AR 72211 | LINCOLN NATIONAL LIFE INS CO | $624 | — | $624 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| QUALCHOICE EIN 71-0794605 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $47K |
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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 229 | $56K |
| Vision | DELTA DENTAL | 222 | $16K |
| Life insurance | LINCOLN NATIONAL LIFE INS CO | 164 | $4K |
| Short-term disability | TRUSTMARK INSURANCE COMPANY | 66 | $36K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH FINANCIAL SERVICES | 149 | $294K |
| Other(4 contracts, 3 carriers) | TRUSTMARK INSURANCE COMPANY | 164 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.