| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD GBS FINANCE 0 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF INDIANA | $51K | $0 | $51K | 10.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $14K | $3K | $18K | 18.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $9K | $3K | $12K | 15.34% |
| LINC HOLDINGS LLC3 | 601 S MERIDIAN ST STE 500 INDIANAPOLIS, IN 46225 | SYMETRA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $9K | $3K | $12K | 19.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 44114 | SYMETRA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 16.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $0 | $852 | $852 | 4.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $2K | $697 | $3K | 20.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $559K |
| SAVE ON SP, LLP EIN 47-3603390 NONE | Accounting (including auditing) Service code 10 | — | $74K |
| FIRST STOP HEALTH LLC EIN 45-1542956 OTHER | Other fees Service code 99 | — | $50K |
| TRIA HEALTH EIN 27-1515235 OTHER | Other fees Service code 99 | — | $48K |
| BOSE MCKINNEY & EVANS LLP EIN 35-0957980 LEGAL SERVICES | Legal Service code 29 | — | $42K |
| NON PROFIT FINANCIAL SOLUTIONS EIN 20-0257445 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $35K |
| BRADY WARE & SCHOENFELD INC EIN 35-1476702 AUDIT/ TEX SERVICES | Accounting (including auditing) Service code 10 | — | $23K |
| RX BENEFITS EIN 63-1157085 NONE | Claims processing Service code 12 | — | $7K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Other commissions Service code 55 | — | $5K |
| PERPETUAL LLC EIN 20-6544159 BROKER | Other commissions Service code 55 | — | $2K |
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 | 736 | 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) | 736 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 1,274 | $507K |
| Life insurance(5 contracts) | SYMETRA LIFE INSURANCE COMPANY | 0 | $279K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 0 | $13K |
| Long-term disability(5 contracts) | SYMETRA LIFE INSURANCE COMPANY | 0 | $279K |
| Prescription drug(5 contracts, 2 carriers) | RXBENEFITS, INC. | 211 | $0 |
| Stop-loss / reinsurancereinsurance | HIGHMARK LIFE & CASUALTY GROUP | 776 | $1.8M |
| Other(6 contracts) | SYMETRA LIFE INSURANCE COMPANY | 231 | $300K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,274 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.