| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 6525 MORRISON BLVD SUITE 200 CHARLOTTE, NC 28211 | HCC LIFE INSURANCE COMPANY | $3K | — | $3K | 1.08% |
| SHERI HUTCHINS3 | 6525 MORRISON BLVD STE 200 CHARLOTTE, NC 28211 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC | $750 | — | $750 | 0.40% |
| MCNEARY, INC.3 Filed as: MCNEARY, INC | 6525 MORRISON BLVD STE 200 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6525 MORRISON BLVD SUITE 200 CHARLOTTE, NC 28211 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $966 | $9K | 18.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 | Participant communication; Named fiduciary; Other services; Non-monetary compensation; Claims processing; Contract Administrator; Float revenue; Direct payment from the plan Service code 12 | 280 TRUMBULL SUITE 5 HARTFORD, CT 06103 | $532K |
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 | 1,040 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,042 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC | 1,040 | $187K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 572 | $49K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $52K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 572 | $49K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 623 | $246K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 572 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,040 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.