| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 190 RIVERS ROAD SUMMIT, NJ 07901 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $2K | $17K | 17.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 190 RIVERS RD SUMMIT, NJ 07901 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41K | $3K | $44K | 59.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 190 RIVERS ROAD SUMMIT, NJ 07901 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $3K | $33K | 68.60% |
| MAXIM INSURANCE SERVICES INC3 | 18050 SATURN LANE HOUSTON, TX 77058 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 7.11% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $464 | $2K | 4.58% |
| HOUSTON NORMAN HAMILTON0 | 7310 LOVE CREEK MISSOURI CITY, TX 77459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $902 | $504 | $1K | 3.17% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $617 | $521 | $1K | 2.56% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $454 | $101 | $555 | 1.25% |
| KATHERINE ANN KELLY3 | 3505 SAGE ROAD HOUSTON, TX 77056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $268 | $0 | $268 | 0.60% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 983 HOUSTON, TX 77001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $226 | $0 | $226 | 0.51% |
| DONALD GRANT JAMES3 | 2706 TAMPA STREET FRIENDSWOOD, TX 77546 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $82 | $206 | 0.46% |
| EDGHILL ENTERPRISES LLC3 | 3403 E SEEBLING MILE RD GRAND ISLAND, NE 68801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.07% |
| JENNIFER ROSE SMITH3 | 4920 W SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.05% |
| BRAD BIEL0 | 225 GRAND STREET JERSEY CITY, NJ 07302 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $16 | $20 | 0.05% |
| LAURIE J BURNS3 | 303 PLYLER ROAD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.04% |
| WILLIAM KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.03% |
| THE WORKSIGHT GROUP LLC3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $7 | $11 | 0.02% |
| DEIRDRE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.02% |
| APRIL MECHATTO3 | 5107 OBRYAN AVENUE GULFPORT, MS 39507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.02% |
| RONALD OLIANO3 | 9 LONDON COURT NEWTOWN, PA 18940 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| CYNTHIA M ANGEL3 | 1320 DOVE BROOK DRIVE ALLEN, TX 75002 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVENUE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ALLYN INCORPORATED3 | 3013 BROOKFIELD LANE CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| PARRISH J PEACHEE3 | 201 W 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 190 RIVERS ROAD SUMMIT, NJ 07901 | FIRST UNUM LIFE INSURANCE COMPANY | $807 | $40 | $847 | 57.70% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 1.62% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.54% |
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 | 173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 173 | $100K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 93 | $76K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.