| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $49K | $49K | 1.97% |
| LOCKTON COMPANIES, LLC3 | 777 S. FIGUEROA ST, STE 5200 LOS ANGELES, CA 90017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $16K | $16K | 0.63% |
| LOCKTON COMPANIES, LLC3 | C/O COMMERCE BANK PO BOX 843844 KANSAS CITY, MO 64184 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF NORTH CAROLINA | $4K | — | $4K | 2.37% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | DELTA DENTAL OF NORTH CAROLINA | $3K | — | $3K | 2.23% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $277 | $3K | 4.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 1.97% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $520 | $4K | 11.38% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $153 | $3K | 7.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.20% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $101 | $1K | 5.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $722 | — | $722 | 3.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 7.46% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $911 | — | $911 | 3.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 180 PARK AVE, 1ST FLOOR FLORHAM PARK, NJ 07932 | ZURICH AMERICAN INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $309 | $23 | $332 | 6.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $273 | — | $273 | 5.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 144.55% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $282 | $17 | $299 | 7.63% |
| JRW ASSOCIATES INC3 Filed as: JRW ASSOCIATES, INC. | 1616 E MILLBROOK ROAD, SUITE 250 RALEIGH, NC 27609 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 1.40% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 224 | $2.5M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 473 | $149K |
| Vision | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | 417 | $23K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 266 | $56K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 266 | $63K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 266 | $40K |
| Other(4 contracts, 3 carriers) | ZURICH AMERICAN INSURANCE COMPANY | 392 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 473 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.