| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $62K | $0 | $62K | 6.03% |
| MICHELLE GATTIS3 | 6840 CAROTHERS PARKWAY, SUITE 100 FRANKLIN, TN 37067 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $28K | $0 | $28K | 2.69% |
| ANDREW SHEA3 | 6840 CAROTHERS PARKWAY, SUITE 100 FRANKLIN, TN 37067 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $27K | $0 | $27K | 2.64% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | $4K | $16K | 1.57% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 225 KENNETH DRIVE ROCHESTER, NY 14623 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | $0 | $1K | 0.23% |
| CHARLES BACKUS4 | 1903 RIVEREDGE DRIVE ASTOR, FL 32102 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 7.58% |
| USI INSURANCE SERVICES LLC4 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 7.21% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $474 | $0 | $474 | 2.21% |
| PML INC4 Filed as: PML, INC. | 11410 STONECREEK DRIVE PICKERINGTON, OH 43147 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $67 | $0 | $67 | 0.31% |
| CAROL CLINTON SMITH4 Filed as: CAROL CLINTON SMITH MARTIAL TRUST | 3317 WAUWINET WAY NORMAN, OK 73071 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $22 | $0 | $22 | 0.10% |
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 | 2,210 | 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) | 2,215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | PRIORITY HEALTH | 146 | $1.8M |
| Dental(2 contracts) | UNIVERSITY HEALTH ALLIANCE | 27 | $390K |
| Vision(3 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 1,695 | $542K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,210 | $1.0M |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,210 | $1.0M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,210 | $1.0M |
| Prescription drug(4 contracts, 3 carriers) | PRIORITY HEALTH | 146 | $1.8M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,210 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,210 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.