| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $32K | $32K | 1.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $11K | $11K | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $291 | $291 | 0.75% |
| MICHAEL J COVAULT4 Filed as: MICHAEL J. COVAULT | 522 EMORY PEAK DRIVE RICHMOND, TX 77469 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 9.94% |
| SANDRA BOYETT4 | PO BOX 605 DICKINSON, TX 77539 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $125 | $0 | $125 | 0.82% |
| MARK E SULLIVAN4 Filed as: MARK E. SULLIVAN | 9211 FOREST CREEK DRIVE TOMBALL, TX 77375 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $123 | $0 | $123 | 0.81% |
| RONALD L GOTTLIEB4 Filed as: RONALD L. GOTTLIEB | 8840 SNOWY OWL LOOP MISSOURI CITY, TX 77459 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $100 | $0 | $100 | 0.66% |
| GREGORY A BARONE4 Filed as: GREGORY A. BARONE | 21815 RED ASHBERRY TRAIL CYPRESS, TX 77433 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $78 | $0 | $78 | 0.51% |
| LUCY MORENO4 | 501 EAST STASSNEY LANE, SUITE 327 AUSTIN, TX 78745 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $68 | $0 | $68 | 0.45% |
| DAVID R JEZIERSKI4 Filed as: DAVID R. JEZIERSKI | 23726 AYSCOUGH LANE KATY, TX 77493 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $28 | $0 | $28 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $342 | $0 | $342 | 2.90% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $117 | $0 | $117 | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $45 | $45 | 0.38% |
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 | 2,719 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,040 | $576K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,719 | $2.5M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 25 | $12K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,719 | $2.5M |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,755 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,755 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.