| 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 72903 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $36K | $36K | 3.09% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMINSTRATRORS | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $3K | $14K | 18.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $54 | $7K | 10.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6325 RANCH DR LITTLE ROCK, AR 72223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.00% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST STE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.66% |
| 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 | $558 | $558 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6325 RANCH DR LITTLE ROCK, AR 72223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 15.00% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST STE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.57% |
| 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 | $363 | $363 | 1.25% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRISS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 38.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $54 | $5K | 18.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $94 | $94 | 0.34% |
| 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 | — | $2K | 8.99% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST STE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.59% |
| 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 | $283 | $283 | 1.25% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 24.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $54 | $2K | 11.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $33 | $33 | 0.22% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 38.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $54 | $3K | 18.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $49 | $49 | 0.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| 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 BRIDGEWATER, NJ 08007 | $51K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 INSURANCE AGENCY | Insurance agents and brokers; Insurance services Service code 22 | 22703 NETWORK PLACE CHICAGO, IL 606731227 | $36K |
| UNUM LIFE INSURAN EIN 01-0278678 INSURANCE AGENCY | Insurance agents and brokers; Insurance services Service code 22 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $24K |
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 | 139 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 213 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 190 | $73K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 190 | $73K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 135 | $52K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 97 | $45K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 97 | $45K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 135 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.