| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL FLOOR 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.01% |
| GPA3 | 12770 MERIT DRIVE DALLAS, TX 75251 | RELIASTAR LIFE INSURANCE COMPANY | — | $13K | $13K | 2.75% |
| GPA3 | 12770 MERIT DRIVE DALLAS, TX 75251 | AIG | $10K | — | $10K | 10.00% |
| ROMINE GROUP, INC.3 | 221 W. 6TH STREET SUITE 1980 AUSTIN, TX 78701 | CONSECO HEALTH INSURANCE CO | $1K | — | $1K | 12.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS, LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | — | $37 | 2.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $25 | — | $25 | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS, LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $90 | — | $90 | 7.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $70 | — | $70 | 5.98% |
| SHARON K CAREW3 Filed as: SHARON K. CAREW | 2907 ELK RIVER TRAIL BULVERDE, TX 78163 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 1.11% |
| SHARON K CAREW3 Filed as: SHARON K. CAREW | 2907 ELK RIVER TRAIL BULVERDE, TX 78163 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 1.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | — | $12 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 1.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS, LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | — | $26 | 4.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | — | $20 | 3.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS, LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $40 | — | $40 | 8.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $28 | — | $28 | 6.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS, LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $28 | — | $28 | 8.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | — | $20 | 6.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP & PENSION ADMINISTRATORS, INC EIN 75-1617587 BENEFIT ADMINISTRATOR | Other services; Claims processing; Plan Administrator Service code 12 | — | $266K |
| CATTO & CATTO BENEFITS, LLP EIN 74-2765358 BROKER | Insurance agents and brokers Service code 22 | — | $85K |
| GUNN GP, LLC EIN 74-3013501 OWNED BY PLAN SPONSOR | Other fees Service code 99 | — | $79K |
| DIXON HUGHES GOODMAN LLP EIN 56-0747981 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $13K |
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 | 624 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 628 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 4 | $5K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,511 | $504K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 798 | $42K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,511 | $504K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,511 | $504K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,511 | $504K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 611 | $478K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,511 | $611K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,511 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.