| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $761 | $6K | 8.72% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $4K | $4K | 5.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 14.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $704 | $704 | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 13.68% |
| OSTLER INSURANCE, LLC3 | 14214 SOUTH REDWOOD ROAD, SUITE 200 BLUFFDALE, UT 84065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $411 | $411 | 1.56% |
| PETERSON INSURANCE SERVICES, LLC3 | 9101 WEST FAIRVIEW AVENUE BOISE, ID 83704 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $206 | $0 | $206 | 0.78% |
| XTREME TEAM, LLC4 | 45 NORTH 300 EAST SAINT GEORGE, UT 84770 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $125 | $0 | $125 | 3.97% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $119 | $0 | $119 | 3.78% |
| STAMMINGER, INC.4 | 188 EAST 200 SOUTH AMERICAN FORK, UT 84003 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $51 | $0 | $51 | 1.62% |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 68 | $67K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 68 | $67K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $44K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $44K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.