| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 1.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | RELIASTAR LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| BENE RE LLC3 | 5217 MONROE STREET, SUITE B TOLEDO, OH 43623 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $5K | $5K | 8.00% |
| ELSON HARKEMA4 Filed as: ELSON JAMES HARKEMA REVOCABLE TRUST | 305 AGOLI LANE LOUDON, TN 37774 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 6.60% |
| JACQUELINE TURKEY HARKEMA REV TRUST4 Filed as: JACQUELINE TUCKEY HARKEMA REV TRUST | 305 AGOLI LANE LOUDON, TN 37774 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $423 | $0 | $423 | 2.20% |
| HEATHER PINARD4 | 33526 MELTON STREET WESTLAND, MI 48186 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $213 | $0 | $213 | 1.11% |
| MICHAEL A. COONS4 | 8581 MARR HIGHWAY MANITOU BEACH, MI 49253 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $61 | $0 | $61 | 0.32% |
| MILDRED ROLLER WHITE4 | 9250 GRANDVILLE AVENUE DETROIT, MI 48228 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $36 | $0 | $36 | 0.19% |
| GLEN N. COOK4 | 2067 NEVADA STREET TOLEDO, OH 43605 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $27 | $0 | $27 | 0.14% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER AND ASSOCIATES, LLC | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $26 | $0 | $26 | 0.14% |
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 | 948 | 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) | 948 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,328 | $71K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 948 | $258K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 948 | $258K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 948 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,328 | — |
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."
No prospect flags tripped on this filing.