| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: TEXAS ASSOCIATES INSURORS AGENCY SA | 70 NORTH EAST LOOP 410 SUITE 520 SAN ANTONIO, TX 78216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | — | $13K | 4.50% |
| BENEFIT CONCEPTS INC3 Filed as: BENEFIT CONCEPTS, INC | 1173 BRITTMOORE RD HOUSTON, TX 77043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5 | — | $5 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: TEXAS ASSOCIATES INSURORS AGENCY SA | 70 NORTH EAST LOOP 410 SUITE 520 SAN ANTONIO, TX 78216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | — | $11K | 7.98% |
| BENEFIT CONCEPTS INC3 Filed as: BENEFIT CONCEPTS, INC | 1173 BRITTMOORE RD HOUSTON, TX 77043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $34 | — | $34 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: TEXAS ASSOCIATES INSURORS AGENCY SA | 70 NE LOOP 410 760 SAN ANTONIO, TX 78216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 9.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: TEXAS ASSOCIATES INSURORS AGENCY SA | 70 NORTH EAST LOOP 410 SUITE 520 SAN ANTONIO, TX 78216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 6.99% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $180 | $180 | 0.19% |
| MGIS3 | 111 SOUTH MAIN STREET SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $30 | $30 | 0.03% |
| BENEFIT CONCEPTS INC3 | 1173 BRITTMOORE RD HOUSTON, TX 77043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5 | — | $5 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: TEXAS ASSOCIATES INSURORS AGENCY SA | 70 SOUTH EAST LOOP 410 SUITE 520 SAN ANTONIO, TX 78216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $705 | — | $705 | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS, INC EIN 35-1846036 | Plan Administrator; Claims processing; Other services Service code 12 | 6133 NORTH RIVER RD SUITE 900 ROSEMONT, IL 60018 | $128K |
| AETNA PPO EIN 06-6033492 | Other services; Claims processing Service code 12 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $63K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 | Claims processing; Other services Service code 12 | 7400 WEST CAMPUS ROAD SUITE 300 NEW ALBANY, OH 43054 | $18K |
| MULTIPLAN, INC EIN 13-3068979 | Other services; Claims processing; Plan Administrator Service code 12 | 115 FIFTH AVENUE 7TH FLOOR NEW YORK, NY 10003 | $17K |
| SUN LIFE ASSURANCE COMPANY OF CANAD EIN 38-1082080 SERVICE PROVIDER | Plan Administrator Service code 14 | — | $12K |
| TELADOC EIN 04-3705970 | Other services; Claims processing; Plan Administrator Service code 12 | 2 MANHATTANVILLE RD PURCHASE, NY 10577 | $6K |
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 | 500 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 308 | $97K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 500 | $94K |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 308 | $234K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 487 | $289K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 341 | $806K |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 500 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 500 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.