| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $16K | $16K | 1.60% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES INC | 2600 KELLY ROAD SUITE 300 WARRINGTON, PA 18976 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $630 | $630 | 0.06% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $12K | $12K | 1.64% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (PA) INC | 2600 KELLY RD SUITE 300 WARRINGTON, PA 18976 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $471 | $471 | 0.07% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 1801 K STREET, NW SUITE 200 WASHINGTON, DC 20006 | HCC LIFE INSURANCE COMPANY | $20K | $0 | $20K | 3.34% |
| BENEPLACE, INC.3 Filed as: BENEPLACE | — | LEGAL RESOURCES | $5K | $0 | $5K | 4.83% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC WASHINTON DC | PO BOX 415840 BOSTON, MA 02241 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $956 | $68 | $1K | 2.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $631 | $0 | $631 | 1.53% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $478 | $41 | $519 | 1.26% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $478 | $31 | $509 | 1.23% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC WASHINGTON DC | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $104 | $1K | 4.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1 JERICHO PLZ SUITE 200 JERICHO, NY 11753 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $689 | $0 | $689 | 2.62% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $603 | $62 | $665 | 2.53% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $603 | $47 | $650 | 2.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS. SERVICES | 44 BALTIMORE ST CUMBERLAND, MD 21502 | HARTFORD LIFE AND ACCIDENT | $972 | $71 | $1K | 16.09% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 415840 BOSTON, MA 02241 | FIRST UNUM LIFE INSURANCE COMPANY | $328 | $55 | $383 | 17.53% |
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 | 1,850 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 45 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,922 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 962 | $1.1M |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,852 | $1.1M |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 9 | $2K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,826 | $709K |
| Prescription drug(2 contracts, 2 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 962 | $1.1M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,843 | $587K |
| Other(7 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,852 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,852 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.