| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IN 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.25% |
| BOAR ENROLLMENT STRATEGIES3 | 9622 WILTSHIRE DRIVE OOLTEWAH, TN 37363 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $112 | $0 | $112 | 0.08% |
| DAVID W WIGGINS3 Filed as: DAVID WILLIAM WIGGINS | 8900 STATE LINE ROAD, SUITE 350 LEAWOD, KS 66206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $86 | $0 | $86 | 0.06% |
| LGF ENTERPRISES, INC.3 | 1201 CARSON WAY, SUITE 202 GREENWOOD, IN 46143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $80 | $0 | $80 | 0.06% |
| FISK ENTERPRISES, INC.3 | 5349 BROOKS BEND GREENWOOD, IN 46143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $55 | $0 | $55 | 0.04% |
| MICHAEL DEWAYNE STALVEY3 | 9622 WILTSHIRE DRIVE OOLTEWAH, TN 37363 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | $0 | $5 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.44% |
| DAVID W WIGGINS3 Filed as: DAVID WILLIAM WIGGINS | 8900 STATE LINE RD, SUITE 350 LEAWOD, KS 66206 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $944 | $0 | $944 | 2.34% |
| FISK ENTERPRISES, INC.3 | 5349 BROOKS BEND GREENWOOD, IN 46143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $592 | $0 | $592 | 1.47% |
| BOAR ENROLLMENT STRATEGIES3 | 9622 WILTSHIRE DRIVE OOLTEWAH, TN 37363 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $417 | $0 | $417 | 1.03% |
| LGF ENTERPRISES, INC.3 | 1201 CARSON WAY, SUITE 202 GREENWOOD, IN 46143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $388 | $0 | $388 | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $231 | $231 | 0.57% |
| MICHAEL DEWAYNE STALVEY3 | 9622 WILTSHIRE DRIVE OOLTEWAH, TN 37363 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $110 | $0 | $110 | 0.27% |
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 | 192 | 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) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $134K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $175K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $134K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.