| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | BLUE CROSS BLUE SHIELD OF TEXAS | $69K | $1K | $70K | 4.13% |
| ENROLLEASE3 Filed as: KNW GROUP LLC | 505 WATERFORD PARK HWY 169 PLYMOUTH, MN 55441 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $375 | $375 | 0.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 9442 N CAPITAL OF TEXAS HWY PLAZA 1, SUITE 950 AUSTIN, TX 78759 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $227 | $227 | 0.35% |
| ENROLLEASE3 Filed as: KNW GROUP LLC | 505 WATERFORD PARK HWY 169 PLYMOUTH, MN 55441 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $121 | $121 | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 9442 NORTH CAPITAL OF TEXAS HWY PLAZA 1, SUITE 950 AUSTIN, TX 78759 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $71 | $71 | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.96% |
| ENROLLEASE3 Filed as: KNW GROUP LLC | 505 WATERFORD PARK HWY 169 PLYMOUTH, MN 55441 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $123 | $123 | 0.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 9442 NORTH CAPITAL OF TEXAS HWY PLAZA 1, SUITE 950 AUSTIN, TX 78759 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $71 | $71 | 0.41% |
| ENROLLEASE3 Filed as: KNW GROUP LLC | 505 WATERFORD PARK HWY 169 PLYMOUTH, MN 55441 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $28 | $28 | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 9442 N CAPITAL OF TEXAS HWY PLAZA 1, SUITE 950 AUSTIN, TX 78759 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $17 | $17 | 0.44% |
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 359 | $1.7M |
| Dental | BLUE CROSS BLUE SHIELD OF TEXAS | 359 | $1.7M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 125 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $65K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $17K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 359 | — |
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."
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.