| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $0 | $20K | 14.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $11 | $6K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $898 | $898 | 1.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $11 | $11 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $882 | — | $882 | 2.77% |
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 | 215 | 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) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 307 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $75K |
| Vision | VISION SERVICE PLAN | 273 | $32K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 192 | $134K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 192 | $134K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 192 | $134K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 307 | $1.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.