| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $10K | $10K | 0.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP S SUITE 1600 HOUSTON, TX 77027 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $388 | $388 | 1.05% |
| MICHAEL J COVAULT4 | 522 EMORY PEAK DR. RICHMOND, TX 77469 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $2K | — | $2K | 12.35% |
| SANDRA BOYETT4 | PO BOX 605 DICKINSON, TX 77539 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $86 | — | $86 | 0.61% |
| MARK E SULLIVAN4 Filed as: MARK E. SULLIVAN | 9211 FOREST CREEK DR. TOMBALL, TX 77375 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $86 | — | $86 | 0.61% |
| RONALD L GOTTLIEB4 | 8840 SNOWY OWL LOOP MISSOURI CITY, TX 77459 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $82 | — | $82 | 0.58% |
| GREGORY A BARONE4 | 130 CLEAR WATER ST. W MONTGOMERY, TX 77356 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $72 | — | $72 | 0.51% |
| LUCY MORENO4 | 501 E STASSNEY LN. APT 327 AUSTIN, TX 78745 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $63 | — | $63 | 0.44% |
| DAVID R JEZIERSKI4 | 23726 AYSCOUGH LN. KATY, TX 77493 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $26 | — | $26 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 21ST ST. ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 1.28% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - HOUSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $4 | $4 | 0.05% |
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 | 2,462 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 94 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,556 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,883 | $546K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,462 | $1.4M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 21 | $8K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,324 | $492K |
| Other(6 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,539 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,539 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.