| 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 | $211K | — | $211K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGER BENEFITS SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 1.32% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.06% |
| EVEREST FUNERAL PACKAGE LLC5 Filed as: EVEREST FUNERAL PACKAGE | 1300 POST OAK BLVD SUITE 1210 HOUSTON, TX 770563163 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $157 | $157 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES - ITASC | TWO PIERCE PLACE ITASCA, IL 601433141 | COMBINED INSURANCE COMPANY OF AMERICA | $46K | — | $46K | 8.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES -ITASCA | TWO PIECE PLACE ITASCA, IL 601433141 | COMBINED INSURANCE COMPANY OF AMERICA | $254 | — | $254 | 9.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE PRUDENTIAL INSURANCE CO OF AMER EIN 22-1211670 | Contract Administrator Service code 13 | — | $174K |
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 | 4,031 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,031 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 36 | $3K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,031 | $2.1M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,031 | $2.1M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,031 | $2.1M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,031 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,643 | — |
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.