| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 6.82% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 3.41% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.17% |
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 7.76% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD, STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.88% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.25% |
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.65% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD, STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.82% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.35% |
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.67% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD, STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.84% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $915 | — | $915 | 2.33% |
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.96% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD, STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.98% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $625 | — | $625 | 2.04% |
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.81% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD, STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $782 | $782 | 3.91% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $438 | — | $438 | 2.19% |
| JN SAVASTA CORP3 | 1350 BROADWAY, SUITE 410 NEW YORK, NY 10018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $541 | — | $541 | 7.70% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1607 N AURORA RD, STE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $271 | $271 | 3.86% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $161 | — | $161 | 2.29% |
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 | 178 | 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) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 168 | $236K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 168 | $236K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $79K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $50K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.