| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $336 | $336 | 0.02% |
| ALTERITY GROUP3 Filed as: ALTERITY GROUP LLC | 340 MADISON AVE FL 21 NEW YORK, NY 10173 | RELIASTAR LIFE INSURANCE COMPANY | $35K | $53K | $88K | 10.03% |
| BENEPLACE, INC.3 Filed as: BENEPLACE | — | LEGAL RESOURCES | $6K | $0 | $6K | 5.92% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC WASHINTON DC | PO BOX 415840 BOSTON, MA 02241 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $505 | $32 | $537 | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $336 | $0 | $336 | 1.01% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $253 | $19 | $272 | 0.82% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $253 | $15 | $268 | 0.81% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC WASHINGTON DC | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $811 | $56 | $867 | 3.69% |
| 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 | $556 | $0 | $556 | 2.37% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $406 | $34 | $440 | 1.87% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $406 | $25 | $431 | 1.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | HARTFORD LIFE AND ACCIDENT | $972 | $49 | $1K | 15.75% |
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 | 1,786 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 69 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,902 | 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. | 970 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,875 | $1.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,875 | $1.5M |
| Prescription drug(2 contracts, 2 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 970 | $1.1M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 2,537 | $879K |
| Other(6 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,995 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,537 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.