| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER VOLUNTARY BNFTS LLC | PO BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 9.97% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 8.75% |
| WILSON CHRISTOPHER J | 6575 PFEIL ROAD SHERTZ, TX 78154 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $140 | — | $140 | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER VOLUNTARY BNFTS LLC | P O BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $121 | — | $121 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BNFT SVCS INC | 9442 CAPITAL OF TEXAS HWY N PLAZA 1 STE 950 AUSTIN, TX 78759 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $81 | — | $81 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER VOLUNTARY BNFTS LLC | P O BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 8.63% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 7.68% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER VOLUNTARY BNFTS LLC | P O BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $125 | — | $125 | 0.73% |
| WILSON CHRISTOPHER J | 6575 PFEIL ROAD SCHERTZ, TX 78154 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $92 | — | $92 | 0.53% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BNFT SVCS INC | 9442 CAPITAL OF TEXAS HWY N PLAZA 1 STE 950 AUSTIN, TX 78759 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | — | $10 | 0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $171K |
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 | 458 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 458 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTH CARE INSURANCE COMPANY | 48 | $570K |
| Dental | UNITEDHEALTH CARE INSURANCE COMPANY | 48 | $570K |
| Vision | UNITEDHEALTH CARE INSURANCE COMPANY | 48 | $570K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 301 | $155K |
| Short-term disability(2 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 118 | $37K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 301 | $155K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTH CARE INSURANCE COMPANY | 48 | $570K |
| Other | COMPSYCH | 350 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.