| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STANDARD INSURANCE COMPANY3 | 2850 GULF RD ROLLING MEADOWS, IL 60006 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| STANDARD INSURANCE COMPANY3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $771 | — | $771 | 2.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD ROLLING MEADOWS, IL 60006 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 14.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $742 | — | $742 | 2.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $662 | — | $662 | 2.05% |
| BOULDER ADMINISTRATION SERVICES4 | P.O. BOX 1046 BOULDER, MT 59632 | HCC LIFE INSURANCE COMPANY | $1K | — | $1K | 5.13% |
| BRUCE WAGNER4 | 715 SOUTH WASHINGTON BOULDER, MT 59632 | HCC LIFE INSURANCE COMPANY | $1K | — | $1K | 4.86% |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 237 | $35K |
| Short-term disability | STANDARD INSURANCE COMPANY | 165 | $38K |
| Long-term disability | STANDARD INSURANCE COMPANY | 166 | $32K |
| Other | HCC LIFE INSURANCE COMPANY | 167 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.