| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 540 WEST MADISON STREET, SUITE 1200 CHICAGO, IL 60661 | REGENCE BLUESHIELD | $16K | $0 | $16K | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $200K | $200K | 3.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $38K | $0 | $38K | 5.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $0 | $98K | $98K | 15.00% |
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 | 4,220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 119 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 77 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 819 | $6.0M |
| Vision(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 3,349 | $6.8M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,776 | $5.9M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,776 | $5.9M |
| Prescription drug | REGENCE BLUESHIELD | 819 | $6.0M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,776 | $7.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,776 | — |
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."
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.