| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 501 FELLOWSHIP ROAD, SUITE 201 MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $11K | $784 | $12K | 6.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE, SUITE 300 MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $8K | — | $8K | 4.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN TACOMA, WA 98402 | AETNA LIFE INSURANCE COMPANY | — | $115 | $115 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 18.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $191 | $191 | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 8TH FLOOR ITASCA, IL 60143 | USABLE LIFE | $2K | — | $2K | 9.99% |
| CONNEXION INSURANCE SOLUTIONS3 Filed as: CONNEXION INSURANCE SOLUTIONS, INC. | PO BOX 34315 SEATTLE, WA 98124 | USABLE LIFE | $1K | — | $1K | 7.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $563 | $563 | 4.33% |
| UNKNOWN3 | UNKNOWN MARYSVILLE, WA 98271 | WELLSPRING FAMILY SERVICES, EAP | $576 | — | $576 | 8.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $571 | — | $571 | 19.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | LIFEMAP ASSURANCE COMPANY | $268 | — | $268 | 15.01% |
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 | 258 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH OPTIONS, INC. | 384 | $1.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 430 | $195K |
| Vision | GROUP HEALTH OPTIONS, INC. | 384 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 258 | $31K |
| Short-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 21 | $16K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 21 | $16K |
| Prescription drug | GROUP HEALTH OPTIONS, INC. | 384 | $1.4M |
| Other(3 contracts, 3 carriers) | USABLE LIFE | 271 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 430 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.