| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITEDHEALTHCARE INSURANCE COMPANY | $60K | $0 | $60K | 4.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 MADISON AVENUE, 28TH FLOOR NEW YORK, NY 10017 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 9.25% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCE | 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | FIRST UNUM LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | — | $1K | $1K | 2.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST, PLAZA 2 250 PEHLE AVENUE, SUITE 400 SADDLE BROOK, NJ 07663 | FIRST UNUM LIFE INSURANCE COMPANY | $613 | $50 | $663 | 5.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 MADISON AVENUE, 28TH FLOOR NEW YORK, NY 10017 | FIRST UNUM LIFE INSURANCE COMPANY | $250 | $0 | $250 | 2.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $61 | $0 | $61 | 0.54% |
| THOMAS CHRISTOPHER SMITH3 | 798 BERRY ROAD NASHVILLE, TN 37204 | FIRST UNUM LIFE INSURANCE COMPANY | $46 | $0 | $46 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & COMPANY | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO OF NY | $1K | — | $1K | 13.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST, PLAZA TWO 250 PEHLE AVENUE, SUITE 400 SADDLE BROOK, NJ 07663 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO OF NY | $2 | — | $2 | 0.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 1.97% |
| THOMAS CHRISTOPHER SMITH3 | 798 BERRY ROAD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 1.45% |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 134 | $1.4M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 134 | $1.4M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO OF NY | 82 | $9K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 102 | $52K |
| Short-term disability(3 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 102 | $64K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 102 | $52K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 134 | $1.4M |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 102 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.