| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDREW SHEA3 | 6840 CAROTHERS PARKWAY, SUITE 100 FRANKLIN, TN 37067 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | $0 | $15K | 1.50% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $0 | $9K | 0.88% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 1.94% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES | 6967 SOUTH RIVER GATE DRIVE MIDVALE, UT 84047 | PREPAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 10.00% |
| CHARLES BACKUS4 | 1903 RIVEREDGE DRIVE ASTOR, FL 32102 | PREPAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 7.00% |
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 | 2,219 | 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) | 2,219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PRIORITY HEALTH | 148 | $1.8M |
| Dental | UNIVERSITY HEALTH ALLIANCE | 26 | $189K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 1,504 | $331K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,219 | $1.0M |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,219 | $1.0M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,219 | $1.0M |
| Prescription drug(3 contracts, 3 carriers) | PRIORITY HEALTH | 148 | $1.8M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,219 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,219 | — |
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.