| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWPORT PLACE DRIVE SUITE 650 NEWPORT BEACH, CA 92660 | MINNESOTA LIFE INSURANCE COMPANY | $19K | — | $19K | 7.59% |
| ANDREW L MOORE3 Filed as: ANDREW R TORELLI | C/O E3 FINANCIAL 4100 NEWPORT BEACH PL DR SUITE 650 NEWPORT BEACH, CA 92660 | MINNESOTA LIFE INSURANCE COMPANY | $6K | — | $6K | 2.41% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | MINNESOTA LIFE INSURANCE COMPANY | — | $5K | $5K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4100 NEWPORT PLACE DRIVE SUITE 650 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | — | $18K | 10.00% |
| BENEFIT ADVISORS SERVICES3 | 1120 SANCTUARY PARKWAY SUITE 375 ALPHARETTA, GA 30009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 2.00% |
| ANDREW L MOORE3 Filed as: ANDREW R. TORELLI | 4100 NEWPORT PLACE DRIVE SUITE 650 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $17K | — | $17K | 10.00% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 | 1120 SANCTUARY PARKWAY SUITE 375 ALPHARETTA, GA 30009 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4100 NEWPORT PLACE DRIVE SUITE 650 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $2K | $13K | 12.11% |
| BENEFIT ADVISORS SERVICES3 | 1120 SANCTUARY PARKWAY SUITE 375 ALPHARETTA, GA 30009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 4100 NEWPORT PLACE DRIVE SUITE 650 NEWPORT BEACH, CA 92660 | MINNESOTA LIFE INSURANCE COMPANY | $8K | — | $8K | 7.58% |
| ANDREW L MOORE3 Filed as: ANDREW R TORELLI | C/O E3 FINANCIAL 4100 NEWPORT PL DR SUITE 250 NEWPORT BEACH, CA 92660 | MINNESOTA LIFE INSURANCE COMPANY | $3K | — | $3K | 2.42% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | MINNESOTA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.00% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51K | $4K | $55K | 53.22% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | $4K | $55K | 53.94% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41K | $6K | $47K | 48.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 4100 NEWPORT PLACE DRIVE SUITE 650 NEWPORT BEACH, CA 92660 | MINNESOTA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.53% |
| ANDREW L MOORE3 Filed as: ANDREW R TORELLI | C/O E3 FINANCIAL 4100 NEWPORT PL DR SUITE 650 NEWPORT BEACH, CA 92660 | MINNESOTA LIFE INSURANCE COMPANY | $621 | — | $621 | 2.47% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | MINNESOTA LIFE INSURANCE COMPANY | — | $503 | $503 | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC. | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 432152153 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $465 | — | $465 | 14.99% |
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 | 1,817 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 71 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,888 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,596 | $177K |
| Life insurance(2 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 2,764 | $362K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 307 | $97K |
| Long-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,606 | $457K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,817 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,764 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.