| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5401 ROGERS AVE STE 202 FORT SMITH, AR 729033767 | UNITED HEALTHCARE | $0 | $34K | $34K | 3.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE CO | $7K | $41 | $7K | 9.94% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMINISTRATION | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE CO | $0 | $3K | $3K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 787669201 | METROPOLITAN LIFE INSURANCE CO | $0 | $823 | $823 | 1.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE CO | $0 | $8 | $8 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6325 RANCH DR 11TH FLOOR LITTLE ROCK, AR 72223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 15.00% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST STE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $210 | $2K | 5.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $679 | $679 | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6325 RANCH DR LITTLE ROCK, AR 72223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST STE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $179 | $2K | 5.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $566 | $566 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6325 RANCH DR LITTLE ROCK, AR 72223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 9.42% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST STE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $120 | $1K | 5.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $400 | $400 | 1.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5401 ROGERS AVE FORT SMITH, AR 72908 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 9.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $303 | $303 | 1.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5401 ROGERS AVE FORT SMITH, AR 72908 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 11.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $291 | $291 | 1.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5401 ROGERS AVE FORT SMITH, AR 72908 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.38% |
| GUY WOLFF3 | P O BOX 80324 CHARLESTON, SC 29416 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 INSURANCE AGENCY | Insurance services; Insurance agents and brokers Service code 22 | 22703 NETWORK PLACE CHICAGO, IL 606731227 | $34K |
| UNUM EIN 01-0278678 INSURANCE AGENCY | Insurance agents and brokers; Insurance services Service code 22 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $22K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 INSURANCE AGENCY | Insurance agents and brokers; Insurance services Service code 22 | 501 U.S. HIGHWAY 22 2ND FLOOR WEST BRIDGEATER, NJ 08807 | $7K |
| AMERICAN HERITAGE LIFE INSURANCE EIN 59-0781901 INSURANCE AGENCY | Insurance agents and brokers; Insurance services Service code 22 | 1776 AMERICAN HERITAGE LIFE DR JACKSONVILLE, FL 32224 | $7K |
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 | 144 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE | 122 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE CO | 96 | $67K |
| Vision | METROPOLITAN LIFE INSURANCE CO | 96 | $67K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $62K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 81 | $44K |
| Other(6 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.