| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | FIRST UNUM LIFE INSURANCE COMPANY | $70K | $28K | $98K | 6.53% |
| RANDALL WARREN PECK3 Filed as: RANDALL W PECK | 7100 CAMINO REAL BOCA RATON, FL 33433 | FIRST UNUM LIFE INSURANCE COMPANY | $707 | $106 | $813 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC. | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $55K | $0 | $55K | 4.29% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | FIRST UNUM LIFE INSURANCE COMPANY | $75K | $12K | $87K | 14.75% |
| RANDALL WARREN PECK3 Filed as: RANDALL W PECK | 7100 CAMINO REAL BOCA RATON, FL 33433 | FIRST UNUM LIFE INSURANCE COMPANY | $85 | $44 | $129 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | ZURICH AMERICAN INSURANCE COMPANY | $13K | $0 | $13K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | ZURICH AMERICAN INSURANCE COMPANY | $7K | $0 | $7K | 15.00% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $451 | $3K | 11.87% |
| RANDALL WARREN PECK3 Filed as: RANDALL W PECK | 7100 CAMINO REAL BOCA RATON, FL 33433 | FIRST UNUM LIFE INSURANCE COMPANY | $20 | $1 | $21 | 0.09% |
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 | 1,228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 79 | $1.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 79 | $1.3M |
| Vision | VISION SERVICE PLAN | 751 | $191K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 981 | $591K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 178 | $23K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 1,482 | $1.5M |
| Other(3 contracts, 2 carriers) | ZURICH AMERICAN INSURANCE COMPANY | 3,513 | $177K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,513 | — |
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.