| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 0.12% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN AND COMPANY LLC | ONE INTEGRITY PARKWAY CLEVELAND, OH 44143 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 0.06% |
| CHRISTINE M. MCCULLUGH3 | 14715 NE 95TH STREET, SUITE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $67K | $0 | $67K | 14.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $244 | $244 | — |
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 | 1,948 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,955 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,903 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,588 | $2.0M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 3,433 | $333K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,903 | $2.8M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 3,903 | $2.8M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,903 | $2.8M |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,588 | $2.0M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 3,903 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,903 | — |
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."
No prospect flags tripped on this filing.