| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVE E, STE 1500 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $904 | $6K | 8.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PL, 21ST FL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 WEST GULF RD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $128 | $128 | 0.21% |
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVE E, STE 1500 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $422 | $4K | 14.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PL, 21ST FL ITASCA, IA 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $686 | — | $686 | 2.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 WEST GULF RD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $57 | $57 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3 SUMMIT PARK DR STE 530 INDEPENDENCE, OH 44131 | VISION SERVICE PLAN | $1K | — | $1K | 4.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 CONSULTANT | Consulting (general); Actuarial Service code 11 | — | $25K |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 132 | $24K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $91K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $62K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 224 | $469K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.