| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF ILLINOIS | $80K | — | $80K | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF ILLINOIS | — | $59K | $59K | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF ILLINOIS | — | $43K | $43K | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL | $102K | — | $102K | 6.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 470 ATLANTIC AVE BOSTON, MA 022102208 | PRUDENTIAL | $77K | — | $77K | 4.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 470 ATLANTIC AVE BOSTON, MA 022102208 | PRUDENTIAL | $6K | — | $6K | 0.36% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL | — | $2K | $2K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAHER BENEFIT SERVICES INC | 2850 GOLD ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 3.28% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $981 | — | $981 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $124 | $124 | 0.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLD ROAD ROLLING MEADOWS, IL 60008 | NEW YORK LIFE GROUP INSURANCE COMPANY | — | $17 | $17 | 1.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Contract Administrator; Claims processing Service code 12 | — | $390K |
| PRUDENTIAL EIN 22-1211670 NONE | Contract Administrator Service code 13 | — | $361K |
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 | 7,229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 210 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 13,520 | $72.1M |
| Vision(3 contracts) | VISION SERVICE PLAN | 4,763 | $742K |
| Life insurance(6 contracts, 2 carriers) | PRUDENTIAL | 6,164 | $3.5M |
| Short-term disability(5 contracts, 3 carriers) | PRUDENTIAL | 6,164 | $1.9M |
| Long-term disability(3 contracts, 2 carriers) | PRUDENTIAL | 6,164 | $1.8M |
| Other | PRUDENTIAL | 200 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,520 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.