| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $24K | $24K | 0.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $0 | $880 | $880 | 0.58% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1120 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $617 | $0 | $617 | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | PO BOX 9465 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $469 | $0 | $469 | 1.26% |
| CHARLES D. BLOCK3 Filed as: CHARLES BLOCK | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $189 | $14 | $203 | 0.54% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $189 | $11 | $200 | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $179 | $0 | $179 | 0.48% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMEN AVENUE IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $15 | $15 | 0.04% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30009 | AMERITAS LIFE INSURANCE CORPORATION | $3K | $0 | $3K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 28932 FRESNO, CA 93729 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $163 | $163 | 0.60% |
| CHARLES D. BLOCK3 Filed as: CHARLES BLOCK | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $575 | $38 | $613 | 2.49% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $575 | $29 | $604 | 2.45% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | PO BOX 9465 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $143 | $0 | $143 | 0.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $137 | $0 | $137 | 0.56% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMEN AVENUE IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $48 | $48 | 0.19% |
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 | 300 | 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) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 337 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 337 | $2.5M |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 475 | $27K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 186 | $176K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 186 | $151K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 186 | $151K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 300 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.