| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $172 | $172 | 0.05% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $28 | $28 | 0.01% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $262 | $3K | 4.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | FIRST UNUM LIFE INSURANCE COMPANY | $253 | — | $253 | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $241 | $28 | $269 | 6.69% |
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 | 797 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 175 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 972 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,473 | $3.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,473 | $2.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,473 | $2.8M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 917 | $373K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 138 | $77K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 917 | $373K |
| Prescription drug(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,473 | $3.6M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 917 | $373K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,473 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.