| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $6K | $17K | 1.76% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $133 | $19 | $152 | 0.02% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $133 | $16 | $149 | 0.02% |
| MARY THERESA FISHER4 | 898 UNION CHURCH ROAD TOWNSEND, DE 19734 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $3K | $0 | $3K | 11.50% |
| LOCKTON COMPANIES, LLC4 | 1801 K STREET NW WASHINGTON, DC 20006 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $2K | $0 | $2K | 7.25% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH AND BENEFITS LLC | 1560 SAWGRASS CORPORATE PLACE SUNRISE, FL 33323 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $163 | $0 | $163 | 0.63% |
| ATKINS NORMAN4 | 2367 TIMBERBROOK TRACE MARIETTA, GA 30066 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $129 | $0 | $129 | 0.50% |
| CHRISTIAN F. ROGNER4 | PO BOX 1318 LEWISBURG, WV 24901 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $78 | $0 | $78 | 0.30% |
| HIGH POINT ALLIANCE4 | 1119 EAST BIRCHBROOK CIRCLE COTTONWOOD HEIGHTS, UT 84047 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $39 | $0 | $39 | 0.15% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $586 | $14 | $600 | 3.49% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, MO 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $324 | $11 | $335 | 1.95% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $292 | $10 | $302 | 1.76% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.10% |
| BCINSOURCING, LLC3 | 6363 COLLEGE BOULEVARD, SUITE 500 OVERLAND PARK, KS 66211 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.10% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | FIRST UNUM LIFE INSURANCE COMPANY | $17 | $0 | $17 | 2.71% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | FIRST UNUM LIFE INSURANCE COMPANY | $9 | $0 | $9 | 1.43% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | FIRST UNUM LIFE INSURANCE COMPANY | $9 | $0 | $9 | 1.43% |
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 | 1,051 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 55 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 901 | $162K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,051 | $1.0M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 66 | $17K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,051 | $986K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,051 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,051 | — |
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.