| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $27K | $0 | $27K | 4.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $14K | $0 | $14K | 4.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DELTA DENTAL OF WISCONSIN | $5K | $0 | $5K | 3.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $64 | $2K | 8.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $385 | $385 | 1.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $822 | $0 | $822 | 6.77% |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 165 | $962K |
| Dental | DELTA DENTAL OF WISCONSIN | 159 | $119K |
| Vision | VISION SERVICE PLAN | 125 | $12K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 210 | $21K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 165 | $962K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 210 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.