| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $41K | $41K | 6.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33K | $0 | $33K | 36.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $8K | $8K | 8.65% |
| PSA FINANCIAL, INC.3 Filed as: PSA FINANCIAL | 11311 MCCORMICK ROAD, SUITE 500 HUNT VALLEY, MD 21031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $38 | $3K | 3.84% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNITE 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $191 | $2K | 1.78% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $80 | $2K | 1.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET, SUITE 200 CHARLOTTE, NC 28209 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $617 | $0 | $617 | 1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | FIRST UNUM LIFE INSURANCE COMPANY | $113 | $0 | $113 | 84.96% |
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 | 1,717 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,734 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 1,784 | $7.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,784 | $7.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,301 | $57K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,717 | $643K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,717 | $643K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,717 | $643K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 1,784 | $7.3M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,717 | $738K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,784 | — |
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.
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.