| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| C. T. HELLMUTH & ASSOCIATES, INC.3 Filed as: C. T. HELLMUTH & ASSOCIATES, INC | 8401 CONNECTICUT AVENUE CHEVY CHASE, MD 20815 | PRINCIPAL LIFE INSURANCE COMPANY | $824 | — | $824 | 1.23% |
| C. T. HELLMUTH & ASSOCIATES, INC.3 | 8401 CONNECTICUT AVENUE CHEVY CHASE, MD 20815 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $797 | $2K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $266 | $266 | 1.00% |
| C. T. HELLMUTH & ASSOCIATES, INC.3 | 8401 CONNECTICUT AVENUE CHEVY CHASE, MD 20815 | LIFE INSURANCE COMPANY OF AMERICA | $3K | $553 | $3K | 17.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF AMERICA | — | $184 | $184 | 0.97% |
| C. T. HELLMUTH & ASSOCIATES, INC.3 | 8401 CONNECTICUT AVENUE CHEVY CHASE, MD 20815 | VISION SERVICE PLAN | $925 | — | $925 | 6.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $299 | — | $299 | 2.59% |
| BENICOR ASSOCIATES INC.3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $212 | — | $212 | 1.84% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 700 W 47TH ST, SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21 | — | $21 | 0.18% |
| C. T. HELLMUTH & ASSOCIATES, INC.3 | 8401 CONNECTICUT AVENUE CHEVY CHASE, MD 20815 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $542 | $158 | $700 | 12.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $53 | $53 | 0.98% |
| C. T. HELLMUTH & ASSOCIATES, INC.3 | 8401 CONNECTICUT AVENUE CHEVY CHASE, MD 20815 | MAGELLAN HEALTH SERVICES | $373 | — | $373 | 12.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 1.83% |
| MARTIN KOOPER3 | 770 LEXINGTON AVENUE 14TH FLOOR NEW YORK, NY 10021 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.31% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 98 | $15K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 132 | $86K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 132 | $27K |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.