| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HNI RISK SERVICES3 Filed as: HNI INSURANCE LLC | 100 JEFFERSON BOULEVARD SUITE 300 WARWICK, RI 02888 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $27K | $27K | 1.65% |
| PGIA, INC.3 Filed as: PGIA INC | 160 GOULD STREET SUITE 122 NEEDHAM HEIGHTS, MA 02888 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $13K | $13K | 0.79% |
| PGIA, INC.3 | 160 GOULD STREET SUITE 122 NEEDHAM, MA 02494 | DELTA DENTAL OF RHODE ISLAND | $4K | — | $4K | 2.49% |
| HNI RISK SERVICES3 Filed as: HNI INSURANCE | 100 JEFFERSON BOULEVARD SUITE 300 WARWICK, RI 02888 | DELTA DENTAL OF RHODE ISLAND | $708 | — | $708 | 0.50% |
| KAREN SUE DARCY3 | 31 HARMONY CROSSING EAST BRIDGEWATER, MA 02333 | AFLAC | $2K | $30 | $3K | 4.45% |
| LAURA N TORRES3 | PO BOX 12373 BEAUMONT, TX 77726 | AFLAC | $1K | — | $1K | 1.83% |
| DAVID PAUL GARDNER3 | 5736 LONGHORN TRAIL SEALY, TX 77474 | AFLAC | $795 | — | $795 | 1.40% |
| BRADFORD M LYTTLE3 | PO BOX 1461 PEMBROOKE, MA 02359 | AFLAC | $776 | $6 | $782 | 1.38% |
| DIANA N MARTINEZ3 | 14016 NORTH LAKE BRANCH LANE HOUSTON, TX 77044 | AFLAC | $620 | $69 | $689 | 1.21% |
| KATHLEEN V LOOPER3 | 66 WALNUT CV DAWSONVILLE, GA 30534 | AFLAC | $369 | — | $369 | 0.65% |
| JAMES E VOGELAAR3 Filed as: JAMES J DUPLESSIS | 601 HENRY LANDRY AVENUE METAIRIE, LA 70003 | AFLAC | $338 | — | $338 | 0.60% |
| PETER K HUYNH3 | 1430 FOUNTAIN VIEW DRIVE APARTMENT 337 HOUSTON, TX 77057 | AFLAC | $311 | — | $311 | 0.55% |
| ISABELLA L PARKER3 | 161 ANNAS LANE ZAVALLA, TX 75980 | AFLAC | $264 | — | $264 | 0.47% |
| MARY E HUCKABEE3 | 1510 RIVERBEND CROSSING SUGAR LAND, TX 77478 | AFLAC | $244 | $14 | $258 | 0.45% |
| MICHAEL A CUTAIA3 | 1225 NORTH LOOP WEST SUITE 214 HOUSTON, TX 77008 | AFLAC | $256 | — | $256 | 0.45% |
| HENRY MESTRES3 | 1 WOODBRIDGE CENTER UNITE 322 WOODBRIDGE, NJ 07095 | AFLAC | $225 | $30 | $255 | 0.45% |
| KAREN TUCCI3 | 73 STETSON DRIVE MARLBOROUGH, MA 01752 | AFLAC | $218 | — | $218 | 0.38% |
| SCOTT C MARTINA3 | 4924 CLEVELAND PLACE METAIRIE, LA 70003 | AFLAC | $168 | — | $168 | 0.30% |
| KAREN J MCDONALD3 | PO BOX 8106 LUMBERTON, TX 77657 | AFLAC | $161 | — | $161 | 0.28% |
| ERIN RADA3 Filed as: ERIN K RADA | 25126 BAYWICK DRIVE SPRING, TX 77389 | AFLAC | $159 | — | $159 | 0.28% |
| DANIEL P CLARK3 | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $158 | — | $158 | 0.28% |
| MICHAEL ANDERS LLC3 | 17802 TERRANOVA WEST DRIVE SPRING, TX 77379 | AFLAC | $134 | — | $134 | 0.24% |
| DANA M SCHMANSKI3 | 23302 PRESERVE VIEW CIRCLE SPRING, TX 77389 | AFLAC | $130 | — | $130 | 0.23% |
| ELLIS G HASSIEN3 | PO BOX 1448 SULPHUR, LA 70664 | AFLAC | $94 | — | $94 | 0.17% |
| BRIAN JASON THOMPSON3 | 103 BEAU REPOSE LAFAYETTE, LA 70508 | AFLAC | $81 | — | $81 | 0.14% |
| KATHLEEN V LOOPER3 | 102 MAPLE RIDGE LAKE DRIVE DAWSONVILLE, GA 30534 | AFLAC | $80 | — | $80 | 0.14% |
| BRYAN J DODGE3 | PO BOX 7433 METAIRIE, LA 70010 | AFLAC | $78 | — | $78 | 0.14% |
| MICHAEL SCOTT ENOS3 | 1602 RUELLE DE GRACE DRIVE BATON ROUGE, LA 70810 | AFLAC | $78 | — | $78 | 0.14% |
| JARED E DAY3 | 19710 CHARA COURT CYPRESS, TX 77433 | AFLAC | $78 | — | $78 | 0.14% |
| KEVIN J NIEDERAUER3 | 150 ALLEN ROAD SUITE 110 BASKING RIDGE, NJ 07920 | AFLAC | $78 | — | $78 | 0.14% |
| LAWRENCE T MATES3 | 925 ORONOKE ROAD UNIT 24F WATERBURY, CT 06708 | AFLAC | $76 | — | $76 | 0.13% |
| DYLAN FRANCIS MONTEFORTE3 | 13 EAGLE NEST ROAD COLTS NECK, NJ 07722 | AFLAC | $59 | $6 | $65 | 0.11% |
| MICHAEL GRASS3 | 21707 KINGSLAND BOULEVARD SUITE 105 KATY, TX 77450 | AFLAC | $59 | — | $59 | 0.10% |
| ERIC D WESTALL3 | 2626 SOUTH LOOP WEST SUITE 340 HOUSTON, TX 77054 | AFLAC | $39 | $14 | $53 | 0.09% |
| CHAD A BROUSSARD3 | 2607 PHYLLIS DRIVE NEW IBERIA, LA 70560 | AFLAC | $44 | — | $44 | 0.08% |
| ANDREW S SHAW3 | 222 FORBES ROAD SUITE 100 BRAINTREE, MA 02184 | AFLAC | $43 | — | $43 | 0.08% |
| MICHAEL P ZILINSKI3 | 271 US HIGHWAY 46 SUITE 0207 FAIRFIELD, NJ 07004 | AFLAC | $34 | $6 | $40 | 0.07% |
| RICHARD DACEY3 | 51 EAST VALLEY BROOK ROAD LONG VALLEY, NJ 07853 | AFLAC | $39 | — | $39 | 0.07% |
| KEVIN BARRY TURK3 | 7803 TWIN HILLS DRIVE HOUSTON, TX 77071 | AFLAC | $37 | — | $37 | 0.07% |
| EDWARD L MARTINA JR3 | 4101 LAKE TRAIL DRIVE KENNER, LA 70065 | AFLAC | $34 | — | $34 | 0.06% |
| MAUREEN E SNOW3 | 68 WINGATE ROAD HOLLISTON, MA 01746 | AFLAC | $32 | — | $32 | 0.06% |
| SHAW ASSOCIATES INC3 | 222 FORBES ROAD SUITE 100 BRAINTREE, MA 02184 | AFLAC | $27 | — | $27 | 0.05% |
| BLAKE CHARLES ADAMS3 | 200 CREEKWOOD DRIVE LAFAYETTE, LA 70503 | AFLAC | $23 | — | $23 | 0.04% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN A PITUCH | PO BOX 335 SPARTA, NJ 07871 | AFLAC | $20 | — | $20 | 0.04% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY SANKA | 861 VOORHEES AVENUE MIDDLESEX, NJ 08846 | AFLAC | $20 | — | $20 | 0.04% |
| CRUSER MARKETING INC3 | 7516 BLUEBONNET BOULEVARD #116 BATON ROUGE, LA 70810 | AFLAC | $14 | — | $14 | 0.02% |
| ERIN RADA3 Filed as: ERIN K RADA | 7911 KLEINGREEN LANE SPRING, TX 77379 | AFLAC | $14 | — | $14 | 0.02% |
| ST THERESE MARKETING INC3 | 4101 LAKE TRAIL DRIVE KENNER, LA 70065 | AFLAC | $14 | — | $14 | 0.02% |
| BRUCE G HILLYER3 | 8 HARVARD DRIVE CARMEL, NY 10512 | AFLAC | $14 | — | $14 | 0.02% |
| JOSHUA PAUL GROUP INC3 | 17 OAK LANE RANDOLPH, NJ 07869 | AFLAC | $14 | — | $14 | 0.02% |
| MICHAEL ANDERS LLC3 Filed as: MICHAEL J ANDERS | 17802 TERRANOVA WEST DRIVE SPRING, TX 77379 | AFLAC | $12 | — | $12 | 0.02% |
| BLAZE J FREMIN3 | PO BOX 53871 LAFAYETTE, LA 70505 | AFLAC | $12 | — | $12 | 0.02% |
| KEITH WILLIAM BELLE3 | 302 LA RUE FRANCE SUITE 100 LAFAYETTE, LA 70508 | AFLAC | $12 | — | $12 | 0.02% |
| BRANDI L TAMOR3 | 939 IBERVILLE STREET APARTMENT 503 NEW ORLEANS, LA 70112 | AFLAC | $11 | — | $11 | 0.02% |
| ERROL B WILKEN3 | 5204 CRAIG AVENUE KENNER, LA 70065 | AFLAC | $11 | — | $11 | 0.02% |
| CHRISTINA MIRABAL3 Filed as: CHRISTINA A MIRABAL | 6311 CAMERON COVE LANE KATY, TX 77450 | AFLAC | $11 | — | $11 | 0.02% |
| MICHAEL GRASS3 | 21707 KINGSLAND BOULEVARD SUITE 105 KATY, TX 77450 | AFLAC | $7 | — | $7 | 0.01% |
| NATHAN A HUMMER3 | 5 WEBBER ROAD WESTFORD, MA 01886 | AFLAC | $7 | — | $7 | 0.01% |
| ALBERT SHUST3 | 200 CENTENNIAL AVENUE SUITE 105 PISCATAWAY, NJ 08854 | AFLAC | $7 | — | $7 | 0.01% |
| EDWARD L MARTINA III3 | 100 GENNA LANE YOUNGSVILLE, LA 70592 | AFLAC | $6 | — | $6 | 0.01% |
| BRANDI L TAMOR3 | 2004 ORMOND BOULEVARD DESTREHAN, LA 70047 | AFLAC | $5 | — | $5 | 0.01% |
| OLIVETTE B LEWIS3 | PO BOX 6127 NEW ORLEANS, LA 70174 | AFLAC | $5 | — | $5 | 0.01% |
| JAMES E VOGELAAR3 | 150 GRUNER ROAD METAIRIE, LA 70001 | AFLAC | $5 | — | $5 | 0.01% |
| JEFF MUSGROVE3 | 3126 PINEY FOREST DRIVE HOUSTON, TX 77084 | AFLAC | $5 | — | $5 | 0.01% |
| JILL SCIRPO3 | 6 WILLETT POND ROAD WESTWOOD, MA 02090 | AFLAC | $4 | — | $4 | 0.01% |
| TODD A STULL3 | 810 SOUTH MASON ROAD SUITE 102 KATY, TX 77450 | AFLAC | $4 | — | $4 | 0.01% |
| LOUIS R FAIOLA3 | 12 HAAWK COURT DELMAR, NY 12054 | AFLAC | $4 | — | $4 | 0.01% |
| ERIC J LEGER3 | 623 EAST 7TH 1/2 STREET HOUSTON, TX 77007 | AFLAC | $3 | — | $3 | 0.01% |
| CHERISE M WADE3 | 1931 HIGHWAY 90 WEST SEALY, TX 77474 | AFLAC | $3 | — | $3 | 0.01% |
| KIM REED SMITH3 | 7815 DEERWOOD LAKE DRIVE HUMBLE, TX 77346 | AFLAC | $3 | — | $3 | 0.01% |
| MAEDE C MILLER3 | 17133 KNOLL DALE TRAIL CONROE, TX 77385 | AFLAC | $3 | — | $3 | 0.01% |
| PRENTISS ATKINS CASTLE JR3 | 7293 DABADIE ROAD VENTRESS, LA 70783 | AFLAC | $3 | — | $3 | 0.01% |
| JAMES E VOGELAAR3 | 4341 FOLSE DRIVE METAIRIE, LA 70006 | AFLAC | $3 | — | $3 | 0.01% |
| FINN INTERESTS INC3 | 1802 LAKE MEADOWS COURT HOUSTON, TX 77077 | AFLAC | $2 | — | $2 | 0.00% |
| TERRY JAMES LAPORTE3 | 1007 HUGH DRIVE SAINT MARTINVILLE, LA 70582 | AFLAC | $2 | — | $2 | 0.00% |
| MICHAEL A FORNARO3 | 271 US HIGHWAY 46 SUITE H119 FAIRFIELD, NJ 07004 | AFLAC | $2 | — | $2 | 0.00% |
| JEREMIAH TROY TALTON3 | 172 BIENVILLE DRIVE MADISON, MS 39110 | AFLAC | $2 | — | $2 | 0.00% |
| REY ROSTAMI3 | PO BOX 625 STOCKHOLM, NJ 07460 | AFLAC | $2 | — | $2 | 0.00% |
| TARA MICHELLE D AGOSTINO3 | 87A BOORAEM AVENUE JERSEY CITY, NJ 07307 | AFLAC | $2 | — | $2 | 0.00% |
| ROBERT JAMES LAMB3 | 53 RIDGEWOOD DRIVE STOW, MA 01775 | AFLAC | $1 | — | $1 | 0.00% |
| TIMOTHY MCDERMOTT3 | 150 ALLEN ROAD SUITE 110 BASKING RIDGE, NJ 07920 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN M LEYPOLDT3 | 67 ALLISON PLACE EGG HARBOR TOWNSHIP, NJ 08234 | AFLAC | $1 | — | $1 | 0.00% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.91% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 14.42% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $228 | — | $228 | 14.98% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 245 | $1.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF RHODE ISLAND | 275 | $199K |
| Vision(2 contracts, 2 carriers) | AFLAC | 67 | $66K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 128 | $24K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 80 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 128 | $17K |
| Other(3 contracts, 2 carriers) | AFLAC | 128 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.