| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STANLEY DOUGLAS GILLESPIE3 | 1228 NORTH 164TH STREET OMAHA, NE 68118 | GUARDIAN | $37K | — | $37K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURNACE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 8.75% |
| GCG FINANCIAL LLC3 | 3 PARKWAY NORTH DEERFIELD, IL 60015 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 6.23% |
| STANLEY DOUGLAS GILLESPIE3 | 1228 NORTH 164TH STREET OMAHA, NE 68118 | GUARDIAN | $8K | — | $8K | 13.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH ADMINISTRATORS, LLC NONE | Contract Administrator Service code 13 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | $175K |
| AETNA LIFE INSURANCE NONE | Insurance agents and brokers Service code 22 | PO BOX 88860 CHICAGO, IL 60695 | $86K |
| GCG FINANICAL LLC NONE | Insurance agents and brokers Service code 22 | 3 PARKWAY N., STE 500 NORCROSS, GA 30092 | $47K |
| USI INSURANCE SERV NATIONAL NONE | Insurance agents and brokers Service code 22 | 100 SUMMIT LAKE DRIVE VALHALLA, NY 10595 | $25K |
| AMERICAN HEALTH HOLDINGS NONE | Insurance agents and brokers Service code 22 | PO BOX 360142 PITTSBURGH, PA 15250 | $16K |
| NOVANET INC NONE | Insurance agents and brokers Service code 22 | 3500 PARKWAY LANE SUITE 440 NORCROSS, GA 30092 | $7K |
| TELADOC INC NONE | Insurance agents and brokers Service code 22 | PO BOX 123417 DALLAS, TX 75312 | $6K |
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 | 509 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 942 | $70K |
| Life insurance | GUARDIAN | 432 | $248K |
| Short-term disability | GUARDIAN | 198 | $55K |
| Long-term disability | GUARDIAN | 432 | $248K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO | 509 | $1.3M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 510 | $335K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 942 | — |
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.