| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 906 W 2ND AVE STE 400 SPOKANE, WA 99201 | PREMERA BLUE CROSS | $92K | $18K | $110K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGER BENEFIT SERVICES INC | 777 108TH AVE NE SUITE 200 BELLEVUE, WA 98004 | DELTA DENTAL OF WASHINGTON | $15K | $0 | $15K | 5.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $0 | $30K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $816 | $816 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 906 W 2ND AVE STE 400 SPOKANE, WA 99201 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $4K | $0 | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FL ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 20.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $500 | $0 | $500 | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $417 | $417 | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 906 W 2ND AVE STE 400 SPOKANE, WA 99201 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $46 | $0 | $46 | 3.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD FLOOR 11 ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $17 | $17 | 1.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15 | $0 | $15 | 1.24% |
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 | 296 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 493 | $3.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 485 | $318K |
| Vision | VISION SERVICE PLAN | 248 | $30K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 18 | $26K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 350 | $203K |
| Prescription drug | PREMERA BLUE CROSS | 493 | $3.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 182 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 493 | — |
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.