| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO | $4K | $0 | $4K | 2.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | AETNA LIFE INSURANCE CO | $2K | $0 | $2K | 1.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 190 RIVER ROAD SUMMIT, NJ 07902 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $189 | $3K | 8.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 WEST GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $246 | $246 | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | EYEMED VISION CARE | $2K | $0 | $2K | 16.34% |
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 | 201 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO | 287 | $157K |
| Vision | EYEMED VISION CARE | 115 | $9K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 198 | $34K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 198 | $34K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 198 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.