| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DR., STE 100 INDIANAPOLIS, IN 46240 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $352K | — | $352K | 12.95% |
| RONALD REMAK3 Filed as: RONALD REMAK INSURANCE INC. | 306 S. STATE ROAD 446 BLOOMINGTON, IN 47401 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $133K | — | $133K | 4.90% |
| DG3 NORTH AMERICA INC0 Filed as: DG3 NORTH AMERICA INC. | 100 BURMA ROAD JERSEY CITY, NJ 07305 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $27K | $27K | 0.99% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP INC. | 210 6TH AVE., 30TH FLOOR PITTSBURGH, PA 15222 | HIGHMARK INC. | $65K | — | $65K | 3.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3838 CAMINO DEL RIO N STE 200 SAN DIEGO, CA 921081741 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER - IRVINE | P. O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | KAISER FOUNDATION HEALTH PLAN INC. | — | $1K | $1K | 0.30% |
| PHILIP N. MCKELVEY3 | 3931 S DIXIE DRIVE DAYTON, OH 45439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 2.09% |
| M J INSURANCE INC.3 Filed as: M-J INSURANCE INC. | 9225 PRIORITY WAY WEST DR., STE 100 INDIANAPOLIS, IN 46240 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.44% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F REMAK INSURANCE INC. | 306 STATE ROAD 446 BLOOMINGTON, IN 47401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $702 | — | $702 | 0.24% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AN AON CO. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $361 | $53 | $414 | 0.14% |
| ERNEST FALCO3 | 350 CROWN OAK CENTRE DRIVE LONGWOOD, FL 32750 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $121 | — | $121 | 0.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NAT'L INC. | P. O. BOX 601478 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $121 | — | $121 | 0.04% |
| MARY E. KOGER3 | 14265 MEADOWLAND DRIVE RIVERSIDE, CA 92503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | GBS FINANCE 2850 GOLF ROAD FL 5 ROLLING MDWS, IL 600084050 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.19% |
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 | 8,337 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 8,337 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HIGHMARK INC. | 239 | $2.6M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 254 | $107K |
| Vision(2 contracts, 2 carriers) | HIGHMARK INC. | 239 | $2.2M |
| Life insurance(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,337 | $4.4M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,785 | $2.7M |
| Long-term disability(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,337 | $4.1M |
| Prescription drug | HIGHMARK INC. | 239 | $2.2M |
| Other(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,337 | $4.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,337 | — |
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.