| 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 | $372K | $23K | $396K | 8.16% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $58K | $27K | $85K | 1.76% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $49K | $37K | $86K | 11.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $36K | $0 | $36K | 4.87% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19K | $5K | $24K | 3.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $9K | $9K | 1.20% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $3K | $3K | 0.42% |
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK ROAD, SUITE 3 FARMINGTON, CT 06032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $581 | $0 | $581 | 0.08% |
| MJ INSURANCE3 Filed as: GBS, INC. AND VARIOUS AGENTS | 100 MATSONFORD ROAD 4 RADNOR CORP. CENTER, SUITE 510 RADNOR, PA 19087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $154 | $195 | 0.03% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $0 | $4K | $4K | 1.56% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | UNUM INSURANCE COMPANY | $19K | $0 | $19K | 15.16% |
| 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 | $1K | $94 | $1K | 10.15% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $520 | $379 | $899 | 8.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $76 | $15 | $91 | 0.81% |
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 | 1,680 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,705 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CAPITAL HEALTH PLAN | 96 | $1.2M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 2,207 | $177K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,680 | $4.8M |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 238 | $761K |
| Long-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,680 | $5.6M |
| Prescription drug(3 contracts, 3 carriers) | CAPITAL HEALTH PLAN | 96 | $1.2M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,680 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,207 | — |
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.