| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | ANTHEM LIFE AND HEALTH INSURANCE COMPANY | $21K | $0 | $21K | 9.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1000 EAST WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | ANTHEM LIFE AND HEALTH INSURANCE COMPANY | $0 | $3K | $3K | 1.37% |
| ADVANCED VOLUNTARY CONCEPTS INC3 | 75 SOUTH BROADWAY WHITE PLAINS, NY 10601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $21K | $0 | $21K | 16.21% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | THE PAUL REVERE LIFE INSURANCE COMPANY | $9K | $0 | $9K | 7.18% |
| TAMARA LYNN ALVES3 | 514 KISSAM ROAD PEEKSKILL, NY 10566 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.46% |
| THE CLARK GROUP OF SC3 Filed as: THE CLARK GROUP OF SOUTH CAROLINA | 589 WINDMERE DRIVE LEXINGTON, SC 29072 | THE PAUL REVERE LIFE INSURANCE COMPANY | $383 | $0 | $383 | 0.29% |
| DONALD H MATSON3 | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $224 | $65 | $289 | 0.22% |
| ADVANCED BENEFIT SYSTEM INC3 | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | THE PAUL REVERE LIFE INSURANCE COMPANY | $74 | $0 | $74 | 0.06% |
| SHEALY BENEFITS SERVICES INC3 | 215 HOGAN WAY LEXINGTON, SC 29072 | THE PAUL REVERE LIFE INSURANCE COMPANY | $10 | $3 | $13 | 0.01% |
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 | 233 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 528 | $256K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 528 | $256K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE AND HEALTH INSURANCE COMPANY | 233 | $344K |
| Short-term disability | ANTHEM LIFE AND HEALTH INSURANCE COMPANY | 233 | $214K |
| Long-term disability | ANTHEM LIFE AND HEALTH INSURANCE COMPANY | 233 | $214K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE AND HEALTH INSURANCE COMPANY | 233 | $344K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 528 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.