| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 702 KING FAMR BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $94K | $94K | 2.88% |
| USI INSURANCE SERVICES LLC3 | 11350 MCCORMICK ROAD EXECUTIVE PLAZA 3 SUITE 1203 BALTIMORE, MD 21031 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $42K | $42K | 1.27% |
| MATHER & STROHL ADMIN SVC INC5 Filed as: MATHER AND STROHL ADMINISTRATIVE | 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $12K | $12K | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $54 | $5K | 1.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 0.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62189 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $63 | $1K | 0.46% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $848 | $848 | 0.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24 | $24 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-MID ATLA | PO BOX 61007 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 6.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $2K | $9K | 6.45% |
| BUCK GLOBAL LLC3 | 606 SOUTH OLIVE STREET 23RD FLOOR LOS ANGELES, CA 90014 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 3.47% |
| JAY E. BLACK3 Filed as: JAY E BLACK | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 11.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY SUITE 350 ROCKVILLE, MD 20855 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 9.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $528 | $528 | 0.87% |
| ASSUREDPARTNERS3 Filed as: MID ATLANTIC BENFITS GROUP LLC | 203 MARKET STREET SUITE 201 HAVRE DE GRACE, MD 21078 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $474 | — | $474 | 0.78% |
| SONIA A VIDAL-AWBREY3 | 2665 PROSPERITY AVENUE APARTMENT 113 FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.20% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.20% |
| MICHAEL C WALKER3 Filed as: MICHAEL WALKER | 203 MARKET STREET SUITE 201 HAVRE DE GRACE, MD 21078 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $852 | — | $852 | 2.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $367 | — | $367 | 1.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $247 | — | $247 | 0.84% |
| JAY E. BLACK3 Filed as: JAY E BLACK | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $825 | — | $825 | 3.71% |
| USI INSURANCE SERVICES LLC3 | 100 NORTH MAIN STREET WINSTON SALEM, NC 27150 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $125 | — | $125 | 0.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $75 | $75 | 0.34% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.08% |
| VIDAL-AWBREY, SONIA, A3 | 2665 PROSPERITY AVENUE APARTMENT 113 FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, IN | 15800 CRABBS BRCH WAY SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 9.01% |
| USI INSURANCE SERVICES LLC3 | 100 NORTH MAIN STREET WINSTON SALEM, NC 27150 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $784 | $261 | $1K | 7.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $98 | $98 | 0.75% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 116 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 222 | $3.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 605 | $273K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 242 | $29K |
| Life insurance(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 115 | $220K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 115 | $207K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 67 | $147K |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 115 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 605 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.