| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $888 | $0 | $888 | 1.26% |
| MAIN STREET FINANCIAL GROUP3 | 123 E MAIN STREET FOREST CITY, NC 28043 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $326 | $0 | $326 | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $74 | $74 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $752 | $0 | $752 | 1.40% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 123 E MAIN STREET FOREST CITY, NC 28043 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $251 | $0 | $251 | 0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $63 | $63 | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | UNUM INSURANCE COMPANY | $102 | $0 | $102 | 0.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $60 | $60 | 0.35% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNUM INSURANCE COMPANY | $45 | $0 | $45 | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | UNUM INSURANCE COMPANY | $957 | $0 | $957 | 7.45% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNUM INSURANCE COMPANY | $411 | $0 | $411 | 3.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60694 | UNUM INSURANCE COMPANY | $0 | $91 | $91 | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60450 | UNUM INSURANCE COMPANY | $202 | $0 | $202 | 1.59% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNUM INSURANCE COMPANY | $87 | $0 | $87 | 0.68% |
| MAIN STREET FINANCIAL GROUP3 | 123 E MAIN STREET FOREST CITY, NC 28043 | UNUM INSURANCE COMPANY | $43 | $0 | $43 | 0.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $26 | $26 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $327 | $0 | $327 | 6.28% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN INC. | PO BOX 9201 AUSTIN, TX 78766 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $86 | $86 | 1.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $28 | $28 | 0.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CLAIMS | Contract Administrator; Claims processing Service code 12 | — | $177K |
| MAIN STREET INSURANCE AGENT | Insurance agents and brokers Service code 22 | 123 E MAIN STREET FOREST CITY, NC 28043 | $103K |
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 | 363 | 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) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 262 | $193K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 262 | $193K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $20K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $71K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $71K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 270 | $478K |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.