| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 601 UNION STREET SUITE 1000 DALLAS, TX 98101 | CIGNA HEALTH AND LIFE INSURANCE AND AFFILIATES | $222K | $0 | $222K | 8.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 5151 BELTLINE ROAD SUITE 200 DALLAS, TX 75224 | CIGNA HEALTH AND LIFE INSURANCE AND AFFILIATES | $0 | $3K | $3K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201503 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $1K | $10K | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD NORTHEAST SUITE 200 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD NE SUITE 200 ATLANTA, GA 30305 | VISION SERVICE PLAN | $1K | $0 | $1K | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD SUITE 800 ATLANTA, GA 30305 | ACE AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 NORTH JEFFERSON AVENUE ST. LOUIS, MO 63103 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $50 | $0 | $50 | 0.95% |
| TIMOTHY C. FLANAGAN3 Filed as: TIMOTHY C. FLANAGAN JR. | 4350 CONGRESS STREET SUITE 300 CHARLOTTE, NC 28209 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $47 | $0 | $47 | 0.89% |
| JAMES LELAND PHILLIPS3 Filed as: JAMES LELAND PHILLIPS JR. | 5605 GLENRIDGE DRIVE NE SUITE 300 ATLANTA, GA 30342 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $28 | $0 | $28 | 0.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CAREY H. BROWN | 6 CONCOURSE PARKWAY SUITE 2750 ATLANTA, GA 30328 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.15% |
| ANDREW L MOORE3 Filed as: ANDREW L. MOORE | 4695 MACARTHUR COURT SUITE 1000 NEWPORT BEACH, CA 92660 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD SUITE 800 ATLANTA, GA 30305 | ACE AMERICAN INSURANCE COMPANY | $101 | $0 | $101 | 15.05% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE AND AFFILIATES | 580 | $2.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE AND AFFILIATES | 580 | $2.7M |
| Vision | VISION SERVICE PLAN | 195 | $2.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 277 | $2.7M |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 277 | $2.7M |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE AND AFFILIATES | 580 | $2.7M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 280 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 580 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.