| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOWARTH III, FREDERICK W3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $85K | $11K | $97K | 15.80% |
| FREDERICK W. HOWARTH III3 Filed as: FREDERICK HOWARTH III | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $57K | — | $57K | 20.14% |
| IMG5 | 2960 NORTH MERIDAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $91 | $91 | 0.03% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE,USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $18 | $18 | 0.01% |
| HOWARTH III, FREDERICK W3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36K | — | $36K | 22.32% |
| HOWARTH III, FREDERICK W3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 20.84% |
| HOWARTH III, FREDERICK W3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY | $6K | $1K | $7K | 13.66% |
| HOWARTH III, FREDERICK W3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 21.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMIN | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $15K |
| UNUM LIFE INSURANCE CO OF AMERICA EIN 01-0278678 N/A | Other services Service code 49 | — | $14K |
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 | 400 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 926 | $15.9M |
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 926 | $15.9M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 555 | $27K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,212 | $281K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY | 173 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 381 | $613K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 926 | $15.9M |
| Other(5 contracts, 3 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,212 | $620K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,212 | — |
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.
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.