| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $37K | $37K | 2.77% |
| BENNIE INSURANCE, LLC3 | 700 CANAL STREET, SUITE 1 STAMFORD, CT 06902 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $28K | $28K | 2.08% |
| BENNIE INSURANCE, LLC3 | 700 CANAL STREET, SUITE 1 STAMFORD, CT 06902 | DELTA DENTAL OF ARIZONA | $9K | $0 | $9K | 9.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1345 EAST CHANDLER BOULEVARD SUITE 103 PHOENIX, AZ 85048 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 7.77% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 1.19% |
| BENNIE INSURANCE, LLC3 | 700 CANAL STREET, SUITE 1 STAMFORD, CT 06902 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD SUITE 270 PHOENIX, AZ 85012 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $536 | $536 | 0.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 800 CAPITAL CIRCLE SE, UNIT 2 TALLAHASSEE, FL 32301 | TRUSTMARK INSURANCE COMPANY | $6K | $0 | $6K | 21.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD SUITE 270 PHOENIX, AZ 85012 | ASSURITY LIFE INSURANCE COMPANY | $3K | $0 | $3K | 13.28% |
| BENNIE INSURANCE, LLC3 | 200 BROADWAY, 3RD FLOOR NEW YORK, NY 10038 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $759 | $0 | $759 | 5.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 WEST 4TH STREET, SUITE 1300 CINCINNATI, OH 45202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $577 | $0 | $577 | 4.32% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 235 | $1.3M |
| Dental | DELTA DENTAL OF ARIZONA | 228 | $98K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 237 | $13K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $125K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $97K |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 235 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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.