| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5420 LBJ FREEWAY SUITE 400 DALLAS, TX 75240 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $183K | — | $183K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 0.61% |
| EVEREST FUNERAL PACKAGE LLC5 | 1300 POST OAK BLVD SUITE 1210 HOUSTON, TX 770563163 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.10% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES - ITASC | 2850 W GOLF RD, FIFTH FLOOR ROLLING MEADOWS, IL 60008 | COMBINED INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 6.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES - ITASC | TWO PIERCE PLACE ITASCA, IL 601433141 | COMBINED INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 3.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - ITASCA | 2850 W GOLF RD, FIFTH FLOOR ROLLING MEADOWS, IL 60008 | COMBINED INSURANCE COMPANY OF AMERICA | $110 | — | $110 | 5.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - ITASCA | TWO PIERCE PLACE ITASCA, IL 601433141 | COMBINED INSURANCE COMPANY OF AMERICA | $104 | — | $104 | 4.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE PRUDENTIAL INSURANCE CO OF AMER EIN 22-1211670 | Contract Administrator Service code 13 | — | $163K |
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 | 3,760 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,760 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 7,362 | $330K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,760 | $1.8M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,760 | $1.8M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,760 | $1.8M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,760 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,362 | — |
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.