| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA | $0 | $10K | $10K | 2.82% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | SYMETRA | $0 | $3K | $3K | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVS INC | 2850 GOLF RD ROLLING MEADOWS, IL 600084050 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $979 | — | $979 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIRST CHOICE HEALTH NETWORK, INC. EIN 93-2358498 NONE | Contract Administrator; Claims processing Service code 12 | — | $100K |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 349 | $189K |
| Vision | VISION SERVICE PLAN | 171 | $17K |
| Life insurance | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 55 | $33K |
| Stop-loss / reinsurancereinsurance | SYMETRA | 161 | $341K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 349 | — |
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.