| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 30001 TAMPA, FL 33601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 4.99% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.38% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $13 | $1K | 1.92% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $929 | $55 | $984 | 11.23% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $310 | $10 | $320 | 3.65% |
| WELLS FARGO INSURANCE SERVICES3 | 3440 WALNUT AVENUE BUILDING A, 2ND FLOOR FREMONT, CA 94538 | HYATT LEGAL PLANS | $411 | — | $411 | 10.11% |
| WELLS FARGO INSURANCE SERVICES3 | 64 MONROE AVENUE NW, SUITE 300 GRAND RAPIDS, MI 49503 | HYATT LEGAL PLANS | — | $47 | $47 | 1.16% |
| WELLS FARGO INSURANCE SERVICES3 | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | HYATT LEGAL PLANS | — | $34 | $34 | 0.84% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | HYATT LEGAL PLANS | — | $27 | $27 | 0.66% |
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 | 451 | 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) | 451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 777 | $3.4M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 978 | $385K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 448 | $209K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 303 | $64K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 448 | $145K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 777 | $3.4M |
| Other(6 contracts, 6 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 451 | $355K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 978 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.