| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $57K | $5K | $62K | 12.94% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | $3K | $53K | 10.89% |
| CROOM, ROBERT, FRINK3 | 155 BRICKLEBERRY DRIVE ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $672 | $0 | $672 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | PO BOX 6030 PASEDENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $288 | $0 | $288 | 0.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | FILE 50788 LOS ANGELES, CA 90074 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$6K | -$718 | -$6K | -1.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 9.31% |
| JOHNSON RESOURCES3 | 7373 EAST DOUBLETREE RANCH SUITE 200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | PO BOX 6030 PASEDENA, CA 91102 | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | $11 | $0 | $11 | 0.02% |
| IMPACT BENEFIT MANAGEMENT SERVICES3 Filed as: IMPACT BENEFIT MANAGEMENT | 3650 MANSELL ROAD, SUITE 100 ALPHARETTA, GA 30022 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 1.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | PO BOX 6030 PASEDENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 1.18% |
| CROOM, ROBERT, FRINK3 | 155 BRICKLEBERRY DRIVE ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 1.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | FILE 50788 LOS ANGELES, CA 90074 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.35% |
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 | 1,494 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 30 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | 1,015 | $65K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,494 | $483K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,494 | $483K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,494 | $483K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,494 | $485K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,494 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.