| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DELTA DENTAL | $2K | — | $2K | 3.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICS, INC. | 2850 GOLF ROAD STE 1000 ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 17.23% |
| CONNECT SOURCE SOLUTIONS, INC. | 1150 HUNGRY NECK BLVD STE C121 MT PLEASANT, SC 29464 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD STE 1000 ROLLING MEADOWS, IL 60006 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 22.69% |
| CONNECT SOURCE SOLUTIONS, INC.3 | 1150 HUNGRY NECK BLVD STE C121 MT PLEASANT, SC 29464 | STANDARD INSURANCE COMPANY | — | $197 | $197 | 0.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLF ROAD STE 1000 ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 17.08% |
| CONNECT SOURCE SOLUTIONS, INC. | 1155 HUNGRY NECK BLVD SUITE C121 MT PLEASANT, SC 29464 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11219 FINANCIAL CENTRE PKWY, #311 LITTLE ROCK, AR 72211 | MEDICAL AIR SERVICES ASSOCIATION, INC. | $3K | — | $3K | 12.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DELTA DENTAL | $2K | — | $2K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD STE 1000 ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 17.75% |
| CONNECT SOURCE SOLUTIONS, INC. | 1150 HUNGRY NECK BLVD STE C121 MT PLEASANT, SC 29464 | STANDARD INSURANCE COMPANY | — | $464 | $464 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE ADVANTAGE ADMINISTRATORS OF AR EIN 71-0226428 CONTACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $86K |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL AIR SERVICES ASSOCIATION, INC. | 99 | $27K |
| Dental | DELTA DENTAL | 247 | $56K |
| Vision | DELTA DENTAL | 225 | $17K |
| Life insurance | STANDARD INSURANCE COMPANY | 213 | $29K |
| Short-term disability | STANDARD INSURANCE COMPANY | 40 | $32K |
| Long-term disability | STANDARD INSURANCE COMPANY | 21 | $12K |
| Other | STANDARD INSURANCE COMPANY | 41 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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.