| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95148 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $47K | $47K | 5.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $7K | $0 | $7K | 9.16% |
| SYNERGY ENROLLMENT AND BEN., LLC3 | 9370 SKY PARK COURT, SUITE 250 SAN DIEGO, CA 92123 | SUNLIFE ASSURANCE COMPANY OF CANADA | $11K | $0 | $11K | 15.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUNLIFE ASSURANCE COMPANY OF CANADA | $5K | $418 | $5K | 7.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 15.00% |
| SYNERGY ENROLLMENT AND BEN., LLC3 | 3550 CAMINO DEL RIO NORTH SUITE 207 SAN DIEGO, CA 92108 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10 WEST CARMEL DRIVE, SUITE 260 CARMEL, IN 46032 | AVESIS INSURANCE INCORPORATED | $1K | $0 | $1K | 9.99% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS | 3550 CAMINO DEL RIO NORTH SUITE 207 SAN DIEGO, CA 92108 | TRUSTMARK INSURANCE COMPANY | $1K | $0 | $1K | 15.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | TRUSTMARK INSURANCE COMPANY | $956 | $0 | $956 | 11.88% |
| ROBERT J KADZIELAWSKI3 Filed as: ROBERT J. KADZIELAWSKI | 5746 WEST MONONA DRIVE GLENDALE, AZ 85308 | TRANSAMERICA LIFE INSURANCE COMPANY | $579 | $0 | $579 | 8.91% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 EAST DOUBLETREE RANCH SUITE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $229 | $0 | $229 | 3.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | TRANSAMERICA LIFE INSURANCE COMPANY | $70 | $0 | $70 | 1.08% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $887K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 210 | $82K |
| Vision | AVESIS INSURANCE INCORPORATED | 204 | $12K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $74K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $66K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $887K |
| Other(3 contracts, 3 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 104 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.