| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER A. BUSSEY3 Filed as: CHRISTOPHER ALAN | 858 NORTH FRANKLIN STREET, UNIT 204 CHICAGO, IL 60610 | STANDARD INSURANCE COMPANY | $21K | $0 | $21K | 1.19% |
| DANNY S. DONLEY3 | 13260 SAN VINCENTE BOULEVARD FISHERS, IN 46038 | STANDARD INSURANCE COMPANY | $21K | $0 | $21K | 1.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $12K | $0 | $12K | 1.99% |
| SPECTRUM SOURCE BROKERAGE3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | STANDARD INSURANCE COMPANY | $75K | $28K | $103K | 18.79% |
| DANNY S. DONLEY3 | 17919 LUCAS CIRCLE WESTFIELD, IN 46074 | STANDARD INSURANCE COMPANY | $78K | $0 | $78K | 14.25% |
| CHRISTOPHER A. BUSSEY3 | 858 NORTH FRANKLIN STREET, UNIT 204 CHICAGO, IL 60610 | STANDARD INSURANCE COMPANY | $33K | $0 | $33K | 6.06% |
| BRIAN L. HETTMANSPERGER SR.3 | 10835 BENTWATER LANE FISHERS, IN 46037 | STANDARD INSURANCE COMPANY | $22K | $0 | $22K | 3.91% |
| STEPHEN E. CROWE3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | STANDARD INSURANCE COMPANY | $806 | $0 | $806 | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $9K | $0 | $9K | 8.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12750 MERIT DRIVE, SUITE 1000 DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $50K | $3K | $52K | 65.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 14.62% |
| DANNY S. DONLEY3 Filed as: DANNY DONLEY | 1013 MALEVENTUM WAY SPRING HILL, TN 37174 | PETERSEN INTERNATIONAL UNDERWRITERS | $4K | $0 | $4K | 9.52% |
| SOURCE BROKERAGE, INC.3 | 303 WEST OHIO STREET, UNIT 3804 CHICAGO, IL 60654 | PETERSEN INTERNATIONAL UNDERWRITERS | $2K | $0 | $2K | 4.76% |
| SOURCE BROKERAGE, INC.3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | PETERSEN INTERNATIONAL UNDERWRITERS | $2K | $0 | $2K | 4.76% |
| SPECTRUM SOURCE BROKERAGE3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | PETERSEN INTERNATIONAL UNDERWRITERS | $2K | $0 | $2K | 4.76% |
| NELSON, WOODIS & SULLIVAN, INC.3 Filed as: NELSON, WOODIS AND SULLIVAN, INC | 600 SOUTH HIGHWAY 169 SUITE 680 MINNEAPOLIS, MN 55426 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 4.57% |
| SURE LIFE FINANCIAL GROUP LLC3 | 24118 WEST CHICAGO STREET SUITE 100 PLAINFIELD, IL 60554 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $519 | $0 | $519 | 4.61% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC. | 10320 ORLAND PARKWAY, SUITE 102 ORLAND PARK, IL 60467 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $506 | $0 | $506 | 4.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $873 | $0 | $873 | 12.82% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $96 | $96 | 1.41% |
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 | 1,095 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 1,778 | $598K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,396 | $107K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,046 | $1.8M |
| Long-term disability(7 contracts, 5 carriers) | STANDARD INSURANCE COMPANY | 1,046 | $2.4M |
| Other(5 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 1,046 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,778 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.