| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $88K | $93K | 3.31% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $63K | $67K | 2.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 100 MATSONFORD ROAD BUILDING 3, SUITE 100 RADNOR, PA 19087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 5.37% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 3.14% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 EAST 2ND STREET, 1ST FLOOR MEDIA, PA 19063 | TRUSTMARK INSURANCE COMPANY | $728 | $0 | $728 | 4.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | TRUSTMARK INSURANCE COMPANY | $485 | $0 | $485 | 3.26% |
| USI INSURANCE SERVICES LLC4 | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $539 | $0 | $539 | 8.91% |
| TRIBEN INSURANCE SOLUTIONS INC4 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 EAST 2ND STREET, 1ST FLOOR MEDIA, PA 19063 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $268 | $0 | $268 | 4.43% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: AJ GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $233 | $0 | $233 | 3.85% |
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 | 170 | 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) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 381 | $2.8M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 381 | $2.8M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 381 | $2.8M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $139K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $139K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $124K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 381 | $2.8M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 381 | — |
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.