| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | 2711 N HASKELL AVE. STE 2000 DALLAS, TX 75204 | HEALTH CARE SERVICE CORPORATION | $30K | — | $30K | 0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 5420 LBJ FREEWAY, STE 400 DALLAS, TX 75240 | HEALTH CARE SERVICE CORPORATION | -$148 | — | -$148 | -0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 11.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $300 | $6K | 3.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 0.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5420 LBJ FREEWAY DALLAS, TX 75240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 12.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $180 | $4K | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5420 LBJ FREEWAY DALLAS, TX 75240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 12.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $154 | $3K | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 5420 LBJ FREEWAY STE 400 DALLAS, TX 75240 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 6.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | 2711 N. HASKELL AVENUE, SUITE 2000 DALLAS, TX 752042914 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.35% |
| TOTAL BENEFIT SOLUTIONS3 | 7412 UNIVERSITY AVE STE 1 LUBBOCK, TX 79423 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 15.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $331 | $331 | 0.79% |
| DAVIS ALLEN AGENCY INC3 | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $298 | $298 | 0.71% |
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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 1,260 | $6.4M |
| Dental | HEALTH CARE SERVICE CORPORATION | 1,260 | $6.4M |
| Vision | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 185 | $67K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 303 | $328K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $108K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 287 | $190K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 303 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,260 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.