| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | HEALTHKEEPERS, INC. | $17K | $0 | $17K | 1.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | ANTHEM LIFE INSURANCE COMPANY | $9K | $1K | $10K | 9.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET, SUITE 200 CHARLOTTE, NC 28209 | AMERITAS LIFE INSURANCE CORPORATION | $5K | $0 | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 21ST FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $739 | $739 | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 5.84% |
| PHILLIP PORTER GOODRUM3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $991 | $0 | $991 | 4.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $64 | $64 | 0.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 21.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $362 | $362 | 2.33% |
| PHILLIP PORTER GOODRUM3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $321 | $0 | $321 | 2.06% |
| COMMONWEALTH EMPLOYEE BENEFIT SOLUT3 Filed as: COMMONWEALTH EMPLOYEE BENEFIT SOL. | 3300 TYRE NECK ROAD PORTSMOUTH, VA 23703 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $14K | $0 | $14K | 100.04% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHKEEPERS, INC. | 89 | $1.1M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 314 | $103K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 178 | $14K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 234 | $123K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 234 | $108K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 234 | $108K |
| Prescription drug | HEALTHKEEPERS, INC. | 89 | $1.1M |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 234 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
No prospect flags tripped on this filing.