| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 10.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 10.05% |
| MRHEIN BENEFITS CONSULTING, LLC3 Filed as: MRHEIN BENEFITS CONSULTING LLC | 446 COUNTRY CLUB DRIVE LANSDALE, PA 19446 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 4.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $740 | $740 | 1.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES INC. | 204 CEDAR STREET CAMBRIDGE, MD 21613 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $305 | $0 | $305 | 0.53% |
| MJ INSURANCE3 Filed as: CARMEN AIDA CRUZ AND VARIOUS AGENTS | 2707 SARDIS CHASE COURT BUFORD, GA 30519 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $279 | $0 | $279 | 0.48% |
| MWE SOLUTIONS MS3 | 1344 ASHTON ROAD, SUITE 200 HANOVER, MD 21076 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $183 | $0 | $183 | 0.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES INC. | 204 CEDAR STREET CAMBRIDGE, MD 21613 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 7.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $404 | $404 | 0.85% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.31% |
| MRHEIN BENEFITS CONSULTING, LLC3 Filed as: MRHEIN BENEFITS CONSULTING LLC | 446 COUNTRY CLUB DRIVE LANSDALE, PA 19446 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $924 | $0 | $924 | 2.82% |
| MWE SOLUTIONS MS3 | 1344 ASHTON ROAD, SUITE 200 HANOVER, MD 21076 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $261 | $0 | $261 | 0.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $231 | $231 | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES INC. | 204 CEDAR STREET CAMBRIDGE, MD 21613 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4 | $0 | $4 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES INC. | 204 CEDAR STREET CAMBRIDGE, MD 21613 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | 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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NGL | 165 | $11K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 192 | $132K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 192 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $47K |
| Other(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 192 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.