| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES, INC. | 204 CEDAR STREET CAMBRIDGE, MD 21613 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 13.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 4.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $317 | $317 | 0.48% |
| MWE SOLUTIONS MS3 | 1344 ASHTON ROAD, SUITE 200 HANOVER, MD 21076 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $588 | $36 | $624 | 1.40% |
| JAY E. BLACK3 Filed as: JAY A. BLACK | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $588 | $0 | $588 | 1.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $508 | $0 | $508 | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES, INC. | 204 CEDAR STREET CAMBRIDGE, MD 21613 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $369 | $0 | $369 | 0.83% |
| CARMEN AIDA CRUZ3 | 2707 SARDIS CHASE COURT BUFORD, GA 30519 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $122 | $0 | $122 | 0.27% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $122 | $0 | $122 | 0.27% |
| SONIA A VIDAL-AWBREY3 Filed as: SONIA A. VIDAL-AWBREY | 2665 PROSPERITY AVENUE APARTMENT 113 FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $69 | $0 | $69 | 0.15% |
| MWE SOLUTIONS MS3 | 1344 ASHTON ROAD, SUITE 200 HANOVER, MD 21076 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $90 | $2K | 5.91% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $122 | $0 | $122 | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $90 | $0 | $90 | 0.34% |
| SONIA A VIDAL-AWBREY3 Filed as: SONIA A. VIDAL-AWBREY | 2665 PROSPERITY AVENUE APARTMENT 113 FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | $0 | $6 | 0.02% |
| CARMEN AIDA CRUZ3 | 2707 SARDIS CHASE COURT BUFORD, GA 30519 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | $0 | $6 | 0.02% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | $0 | $6 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SVC AND OTHER AGENTS | 204 CEDAR STREET CAMBRIDGE, MD 21613 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | $0 | $5 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | NGL | $1K | $0 | $1K | 10.00% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NGL | 157 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $110K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 134 | $45K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $66K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.