| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 NORTH WINSTON ROAD, SUITE 100 KNOXVILLE, TN 37919 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $751 | $13K | 4.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 4.72% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 4.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 0.49% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $2K | $12K | 22.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 NORTH WINSTON ROAD, SUITE 100 KNOXVILLE, TN 37919 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 6.29% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $121 | $121 | 0.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $6 | $6 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $274 | $0 | $274 | 5.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE COMPANY | PO BOX 10328 KNOXVILLE, TN 37939 | VISION SERVICE PLAN | $212 | $0 | $212 | 3.96% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $22 | $0 | $22 | 0.41% |
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 | 428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 433 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 33 | $5K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 426 | $319K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 426 | $319K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 426 | $264K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 426 | $264K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.