| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 225 NE MIZNER BLVD STE 675 BOCA RATON, FL 33432 | STANDARD INSURANCE COMPANY | $47K | $0 | $47K | 1.99% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DR PO BOX 527 FARMINGTON, CT 06034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.44% |
| DANIEL OWEN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $803 | $0 | $803 | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC-TAMPA | 2502 N ROCKY POINT DR STE 400 TAMPA, FL 33607 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $359 | $0 | $359 | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | CHARLOTTE 613 RIVER PARK RD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $329 | $0 | $329 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | WACHOVIA HQ 227 WEST TRADE ST, STE 1500 CHARLOTTE, NC 28202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $178 | $178 | 0.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS INC - SUMMIT | 190 RIVER RD SUMMIT, NJ 07902 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.03% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DR PO BOX 527 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $227 | $0 | $227 | 5.04% |
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 | 1,890 | 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) | 1,890 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 552 | $69K |
| Vision | EYEMED | 2,549 | $146K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,959 | $2.4M |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,959 | $2.4M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 1,959 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,549 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.