| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $7K | $14K | $20K | 6.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $7K | $3K | $10K | 4.72% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29K | $518 | $29K | 20.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $0 | $18K | 12.35% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $518 | $9K | 6.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 1.39% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES, INC. | 2600 KELLY ROAD, SUITE 300 WARRINGTON, PA 18976 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $312 | $0 | $312 | 0.22% |
| DWIGHT L PIERCE3 Filed as: DWIGHT L. PIERCE | 1200 EAST TAFT AVENUE SAPULPA, OK 74066 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $308 | $0 | $308 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $0 | $20K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.55% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $395 | $26K | 23.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 9.83% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $395 | $6K | 5.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $935 | $935 | 0.85% |
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 | 1,666 | 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) | 1,666 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 1,080 | $327K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,364 | $474K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 232 | $132K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,364 | $221K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 1,666 | $499K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,666 | — |
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.