| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT BURKHARDT3 | 5531 E. INVERNESS DR. POST FALLS, ID 83854 | VISION SERVICE PLAN | $0 | $0 | $0 | 0.00% |
| SCOTT BURKHARDT3 | 5531 E. INVERNESS DR. POST FALLS, ID 83854 | DELTA DENTAL OF ILLINOIS | $0 | $0 | $0 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | — |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $10K | $29K | — |
| MULLINTBG INSURANCE AGENCY SERVICES3 Filed as: MULLINTBG INS AGENCY SERVICE LLC | 33174 COLLECTION CENTER DR. CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $595 | $2K | — |
| M FINANCIAL HOLDING INC3 Filed as: M FINANCIAL HOLDING INC. | 1125 NW COUCH ST., SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $175 | $175 | — |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | — |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1301 DOVE ST., SUITE 200 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 NONE | Insurance services Service code 23 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $11K |
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 | 978 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 978 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 948 | $43K |
| Vision | VISION SERVICE PLAN | 841 | $176K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 978 | $0 |
| Short-term disability(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 978 | $0 |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 978 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 978 | — |
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.