| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MID AMERICA GROUP A DIV OF3 Filed as: MID AMERICA GROUP - A DIV OF | GALLAGHER BENEFIT SERVICES TWO PIERCE PLACE -21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | — | $29K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $14K | $14K | 1.25% |
| KESTRA INVESTMENT SERVICES LLC3 | 5707 SOUTHWEST PKWY STE 2 STE 400 AUSTIN, TX 787356214 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | — | $17K | 3.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $5 | $56 | $61 | 0.01% |
| MID AMERICA GROUP A DIV OF3 | GALLAGHER BENEFIT SVCS TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $31K | — | $31K | 7.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RSI A DIVISION OF GALLAGHER | BENEFIT SERVICES INC. 2 PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | $218 | $21K | 5.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BELMONT, A DIV OF | GALLAGHER BENEFIT SVCS PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $18K | $18K | 4.61% |
| P. FINANCIAL, INC. DBA PFLEGER3 Filed as: P. FINANCIAL, INC. DBA | PFLEGER FINANCIAL GROUP, INC. STE 1010 2600 S DOUGLAS RD CORAL GABLES, FL 33134 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $380 | — | $380 | 0.10% |
| WEISS INSURANCE AGENCY INC3 Filed as: WEISS, GINGER L | 3801 KENNETT PIKE C-104 GREENVILLE, DE 19807 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 10.21% |
| MID AMERICA GROUP A DIV OF3 | GALLAGHER BENEFIT SVCS TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 5.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BELMONT, A DIV OF | OF GALLAGHER BENEFIT SVCS PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $6K | $6K | 3.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RSI A DIVISION OF GALLAGHER | BENEFIT SERVICES INC 2 PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $100 | — | $100 | 0.05% |
| PHILIP GARY WIENKEN3 | 2125 ARBOR COURT MECHANICSBURG, PA 170555879 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $266 | — | $266 | 0.34% |
| CHRISTOPHER A LUPP3 Filed as: CHRISTOPHER CHARLES COCORES | 5001 LOUISE DRIVE SUITE 300 MECHANICSBURG, PA 170556912 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $265 | — | $265 | 0.34% |
| WOODMANSEE & CO.3 Filed as: WOODMANSEE & CO | 525 ROUTE 73 N STE 305 MARLTON, NJ 080533422 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | — | $17K | 23.73% |
| EMERSON REID LLC3 Filed as: EMERSON REID & CO INC | 669 RIVER DRIVE CENTER II STE 305 ATTN EDNA RODDA ELMWOOD PARK, NJ 074071361 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $4K | $8K | 11.13% |
| MID AMERICA GROUP A DIV OF3 | GALLAGHER BENEFIT SVCS TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 7.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RSI A DIVISION OF GALLAGHER | BENEFIT SERVICES INC 2 PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 7.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BELMONT, A DIV OF | GALLAGHER BENEFIT SVCS PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 6.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDAN CENTER SUITE 100 ROCHESTER, NY 14618 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $5K | — | $5K | 12.07% |
| MID AMERICA GROUP A DIV OF3 Filed as: MID AMERICA GROUP, A DIV OF GBS | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | — | $1K | 3.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BELMONT, A DIV | OF GALLAGHER BENEFIT SVCS PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $279 | $279 | 0.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $14 | $14 | 0.03% |
| MID AMERICA GROUP A DIV OF3 Filed as: MID AMERICAN GROUP A DIV OF | GALLAGHER BENEFIT SVCS TWO PIERCE PLACE ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.44% |
| MID AMERICA GROUP3 | ONE COMMERCE SQUARE 2005 MARKET ST. 7TH FLOOR PHILADELPHIA, PA 19103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $234 | — | $234 | 0.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE. HARTFORD, CT 06156 | $596K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 0 | $424K |
| Life insurance(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $1.1M |
| Long-term disability(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $1.9M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 0 | $1.3M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $778K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.