| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | $0 | $22K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERIVCES, INC. | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.25% |
| DAVID W WIGGINS3 Filed as: DAVID WILLIAM WIGGINS | 8900 STATE LINE ROAD, SUITE 350 LEAWOD, KS 66206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | $0 | $5 | 0.00% |
| FISK ENTERPRISES, INC.3 | 5349 BROOKS BEND GREENWOOD, IN 46143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3 | $0 | $3 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.54% |
| DAVID W WIGGINS3 Filed as: DAVID WILLIAM WIGGINS | 8900 STATE LINE ROAD, SUITE 350 LEAWOD, KS 66206 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $934 | $0 | $934 | 2.02% |
| FISK ENTERPRISES, INC.3 | 5349 BROOKS BEND GREENWOOD, IN 46143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $582 | $0 | $582 | 1.26% |
| MJ INSURANCE3 Filed as: LGF ENTERPRISES AND VARIOUS AGENTS | 1201 CARSON WAY GREENWOOD, IN 46143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $432 | $0 | $432 | 0.93% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, SUITE 800 BUFFALO, NY 14204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $357 | $0 | $357 | 0.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERIVCES, INC. | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $254 | $254 | 0.55% |
| MICHAEL DEWAYNE STALVEY3 | 9622 WILTSHIRE DRIVE OOLTEWAH, TN 37363 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $0 | $123 | 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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $279K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $325K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $279K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $325K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.