| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $295K | $27K | $322K | 6.72% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $22K | $43K | 0.89% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $63K | $29K | $92K | 10.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $49K | $13K | $62K | 7.14% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $12K | $30K | 3.39% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $7K | $7K | 0.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $64 | $64 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.01% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $80K | $0 | $80K | 20.03% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $0 | $2K | $2K | 0.95% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | FEDERAL INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $616 | $2K | 16.70% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $733 | $410 | $1K | 8.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $83 | $16 | $99 | 0.75% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $16 | $16 | 0.12% |
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 | 1,795 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,816 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CAPITAL HEALTH PLAN | 97 | $1.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 13 | $15K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 2,268 | $142K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,489 | $4.8M |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 92 | $885K |
| Long-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,489 | $5.7M |
| Prescription drug(3 contracts, 3 carriers) | CAPITAL HEALTH PLAN | 97 | $1.3M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,795 | $5.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,268 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.