| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $238K | — | $238K | 26.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $30K | — | $30K | 10.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $4K | $34K | 16.78% |
| OROPEZA, NOAH3 Filed as: OROPEZA, NOAH G | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $10K | $10K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $2K | $22K | 13.20% |
| MS BENEFITS3 | 100 CHALLENGER RD STE 105 RIDGEFIELD PARK, NJ 07660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 8.00% |
| OROPEZA, NOAH3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | UNUM INSURANCE COMPANY | $9K | — | $9K | 14.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $7K | $748 | $8K | 13.23% |
| MS BENEFITS3 | 100 CHALLENGER RD STE 105 RIDGEFIELD PARK, NJ 07660 | UNUM INSURANCE COMPANY | $5K | — | $5K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $4K | — | $4K | 9.99% |
| OROPEZA, NOAH3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | UNUM INSURANCE COMPANY | $4K | — | $4K | 14.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $3K | $350 | $4K | 13.25% |
| MS BENEFITS3 | 100 CHALLENGER RD STE 105 RIDGEFIELD PARK, NJ 07660 | UNUM INSURANCE COMPANY | $2K | — | $2K | 7.99% |
| OROPEZA, NOAH3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | UNUM INSURANCE COMPANY | $4K | — | $4K | 14.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $3K | $303 | $3K | 13.28% |
| MS BENEFITS3 | 100 CHALLENGER RD STE 105 RIDGEFIELD PARK, NJ 07660 | UNUM INSURANCE COMPANY | $2K | — | $2K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $19 | $2K | 15.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $116 | $1K | 16.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $585 | — | $585 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $830 | — | $830 | 15.00% |
| HARTMAN, HOWARD, STANLEY3 Filed as: HARTMAN, HOWARD STANLEY | 4938 SHADY TRAIL STREET SIMI VALLEY, CA 93063 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 1.96% |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 393 | $904K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 514 | $292K |
| Vision | VISION SERVICE PLAN | 256 | $40K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 259 | $372K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 259 | $202K |
| Long-term disability(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 259 | $228K |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 259 | $491K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 514 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.