| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ATTN AMY WESTERBERG 650 E. CARMEL DR., STE. 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $72K | $81K | 6.27% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 1945 SCOTTSVILLE ROAD SUITE 100 BOWLING GREEN, KY 42104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $4K | $6K | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ATTN AMY WESTERBERG 650 E. CARMEL DR., STE. 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $37K | $78K | $115K | 13.95% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $11K | $17K | 2.09% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 2305 RIVER ROAD LOUISVILLE, KY 40206 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $121K | $9K | $130K | 21.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | ATTN AMY WESTERBERG 650 E. CARMEL DR., STE. 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $19K | $44K | $63K | 11.93% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $6K | $10K | 1.87% |
| ASSUREDPARTNERS5 Filed as: ASSURED PARTNERS NL, LLC | 2305 RIVER ROAD LOUISVILLE, KY 40206 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $23K | — | $23K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ATTN AMY WESTERBERG 650 E. CARMEL DR., STE. 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $14K | $21K | 11.67% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARRTNERS NL, LLC | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $2K | $3K | 1.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ATTN AMY WESTERBERG 650 E. CARMEL DR., STE. 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $9K | $13K | 14.16% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $662 | $1K | $2K | 2.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | ATTN AMY WESTERBERG 650 E. CARMEL DR STE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIF INSURANCE COMPANY | $1K | $637 | $2K | 2.10% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | RELIANCE STANDARD LIF INSURANCE COMPANY | $287 | $162 | $449 | 0.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS, INC EIN 35-1846036 NONE | Other services; Claims processing; Plan Administrator Service code 12 | — | $836K |
| COMMONWEALTH HEALTH CORPORATION EIN 31-1118087 NONE | Claims processing; Other services Service code 12 | — | $301K |
| ACS - A XEROX COMPANY EIN 36-4129784 NONE | Other services; Claims processing Service code 12 | — | $41K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Claims processing; Other services Service code 12 | — | $18K |
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 | 3,470 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 853 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | PARAMOUNT DENTAL, INC. | 3,352 | $1.5M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 4,970 | $387K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,653 | $997K |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,793 | $1.4M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,513 | $530K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 2,329 | $2.5M |
| Other(5 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 4,255 | $946K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,970 | — |
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.