| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED CONCORDIA INSURANCE COMPANY | $4K | $0 | $4K | 4.00% |
| DIFFENDERFER, DENNIS, R3 Filed as: DIFFENDERFER, DENNIS R. | 1120 AUGUSTA CIRCLE NORTH HUNTINGDON, PA 15642 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 19.41% |
| SMITH, THOMAS, CHRISTOPHER3 | P.O. BOX 6650 METAIRIE, LA 70009 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $245 | $3K | 9.17% |
| DENNIS R. DIFFENDERFER3 | 1120 AUGUSTA CIRCLE NORTH HUNTINGDON, PA 15642 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 17.71% |
| SMITH, THOMAS, CHRISTOPHER3 | P.O. BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $168 | $3K | 8.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3600 AMERICAN BLVD. SUITE 500 WEST BLOOMINGTON, MN 55431 | HIGHMARK INC. | $200 | $0 | $200 | 0.94% |
| DIFFENDERFER, DENNIS, R3 Filed as: DIFFENDERFER, DENNIS R. | 1120 AUGUSTA CIRCLE NORTH HUNTINGDON, PA 15642 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 13.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $535 | $0 | $535 | 3.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $339 | $0 | $339 | 1.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 60008 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 10.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $344 | $0 | $344 | 2.02% |
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 | 257 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 298 | $90K |
| Vision | HIGHMARK INC. | 302 | $21K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 257 | $36K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 68 | $50K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 99 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.