| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | BLUECROSS BLUESHIELD OF TEXAS | $227K | $6K | $233K | 3.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $66K | $0 | $66K | 15.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $11K | $11K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM INSURANCE COMPANY | $21K | $0 | $21K | 11.76% |
| TAILORED WORKSITE SERVICES3 Filed as: TAILORED WORKSITE SERVICES, LLC | 1802 LAKE MEADOWS COURT HOUSTON, TX 77077 | UNUM INSURANCE COMPANY | $16K | $0 | $16K | 8.85% |
| DOMINIC RODRIGUEZ3 | 11403 BARKER CYPRESS ROAD SUITE J222 CYPRESS, TX 77433 | UNUM INSURANCE COMPANY | $16K | $0 | $16K | 8.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $1K | $1K | 0.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $9K | $0 | $9K | 10.00% |
No Schedule C service providers reported on this filing.
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 | 450 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 457 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 1,267 | $6.5M |
| Dental | BLUECROSS BLUESHIELD OF TEXAS | 1,267 | $6.5M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 499 | $85K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 436 | $441K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 436 | $441K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 436 | $441K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 1,267 | $6.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 436 | $620K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,267 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.