| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $196K | $0 | $196K | 5.50% |
| FREDERICK W. HOWARTH III3 Filed as: FREDERICK WILLIAM HOWARTH III | TBG WEST 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | MINNESOTA LIFE INSURANCE COMPANY | $113K | $0 | $113K | 4.00% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $472K | $0 | $472K | 30.97% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $920 | $0 | $920 | 0.06% |
| TCS INSURANCE AGENCY INC3 | STE 340 100 SMITH RANCH RD SAN RAFAEL, CA 94903 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $858 | $0 | $858 | 0.06% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | MOUNTAIN WEST 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $493 | $0 | $493 | 0.03% |
| GATEWAY BENEFITS DBA THE3 Filed as: GATEWAY FINANCIAL GROUP INC | SUITE 600 FOUR PPG PLACE PITTSBURGH, PA 15222 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $385 | $0 | $385 | 0.03% |
| PFLEGER FINANCIAL GROUP3 Filed as: PFLEGER FINANCIAL GROUP INC | STE 1010 2600 S DOUGLAS RD CORAL GABLES, FL 33134 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $267 | $0 | $267 | 0.02% |
| DYE & ESKIN INC3 | 1324 VINCENT PL MCLEAN, VA 22101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $210 | $0 | $210 | 0.01% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 02110 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $173 | $0 | $173 | 0.01% |
| ACETI, DANIEL, GINO3 Filed as: ACETI, DANIEL GINO | 7804 FAIRVIEW RD #266 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $119 | $0 | $119 | 0.01% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $91 | $0 | $91 | 0.01% |
| LONGMONT GROUP INC DBA THE PADON CO3 Filed as: LONGMONT GROUP INC DBA | THE PADON COMPANY 5321 LONGMONT DR HOUSTON, TX 77056 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $0 | $71 | 0.00% |
| NAPCO INC3 | 30301 NORTHWESTERN HWY STE 200 FARMINGTON HILLS, MI 48334 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $47 | $0 | $47 | 0.00% |
| KORNREICH, JAMES, DAVID3 Filed as: KORNREICH, JAMES DAVID | 4 PURCHASE HILLS DR PURCHASE, NY 10577 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $0 | $46 | 0.00% |
| PECK FINANCIAL SERVICES INC3 Filed as: PECK FINANCIAL INC | 7100 WEST CAMINO REAL SUITE 403 BOCA RATON, FL 33433 | MINNESOTA LIFE INSURANCE COMPANY | $92K | $0 | $92K | 6.28% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $152K | $0 | $152K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | EAST BUTLER AVENUE SECOND FLOOR AMBLER, PA 19002 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $21K | $0 | $21K | 4.31% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $53K | $0 | $53K | 31.06% |
| PECK FINANCIAL SERVICES INC3 Filed as: PECK FINANCIAL INC | STE 403 7100 CAMINO REAL BOCA RATON, FL 33433 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $390 | $0 | $390 | 0.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | NORTHEAST INC PO BOX 416672 BOSTON, MA 02241 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $347 | $0 | $347 | 0.20% |
| CRAWFORD, KENT, MYRON3 Filed as: CRAWFORD, KENT MYRON | 3620 BIRCH ST 1ST FL NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $296 | $0 | $296 | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $153 | $0 | $153 | 0.09% |
| PFLEGER FINANCIAL GROUP3 | 2600 S DOUGLAS RD STE 1010 CORAL GABES, FL 33134 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $104 | $0 | $104 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 31 EAST BUTLER AVE 1ST FL AMBLER, PA 19002 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $70 | $0 | $70 | 0.04% |
| CONNOLLY, PAUL J3 | 21ST FLOOR TWO PIERCE PL ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $58 | $0 | $58 | 0.03% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $54 | $0 | $54 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | EAST BUTLER AVENUE SECOND FLOOR AMBLER, PA 19002 | DELAWARE AMERICAN LIFE INSURANCE OF AMERICA | $5K | $0 | $5K | 4.31% |
| SEIBERTKECK INSURANCE3 | 2950 WEST MARKET AKRON, OH 44333 | ACE AMERICAN INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.48% |
| GATEWAY BENEFITS DBA THE3 Filed as: GATEWAY FINANCIAL GROUP INC | SUITE 600 FOUR PPG PLACE PITTSBURGH, PA 15222 | THE PAUL REVERE LIFE INSURANCE COMPANY | $395 | $0 | $395 | 1.61% |
| TCS INSURANCE AGENCY INC3 | STE 340 100 SMITH RANCH RD SAN RAFAEL, CA 94903 | THE PAUL REVERE LIFE INSURANCE COMPANY | $307 | $0 | $307 | 1.25% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | THE PAUL REVERE LIFE INSURANCE COMPANY | $112 | $0 | $112 | 0.46% |
| POLLOCK LIFE INS CORPORATION3 Filed as: POLLOCK LIFE INS | CORPORATION 150 PORTOLA RD PORTOLA VALLEY, CA 94028 | THE PAUL REVERE LIFE INSURANCE COMPANY | $30 | $0 | $30 | 0.12% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 20.00% |
| BOXWELL, PHILIP A3 | 2114 53RD ST DES MOINES, IA 50310 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $206 | $0 | $206 | 1.99% |
| TCS INSURANCE AGENCY INC3 | STE 340 100 SMITH RANCH RD SAN RAFAEL, CA 94903 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $189 | $0 | $189 | 1.82% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $124 | $0 | $124 | 1.20% |
| USI INSURANCE SERVICES LLC3 | STE 1100 201 MISSION ST SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $86 | $0 | $86 | 0.83% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $74 | $0 | $74 | 0.71% |
| JAMES M POLLOCK INC3 | 150 PORTOLA RD PORTOLA VALLEY, CA 94028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | $0 | $17 | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11 | $0 | $11 | 0.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TELUS HEALTH (US) LTD. EIN 52-1883918 SERVICE PROVIDER | Other services Service code 49 | — | $88K |
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 | 4,528 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 424 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,952 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 41 | $478K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 41 | $478K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 4,305 | $364K |
| Life insurance(4 contracts, 3 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 4,799 | $4.5M |
| Long-term disability(6 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,114 | $5.4M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,465 | $829K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,799 | — |
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.