| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE BACK, LLC3 Filed as: BLUE BACK HEALTH LLC | 20 WESTERN BOULEVARD GLASTONBURY, CT 06033 | ANTHEM LIFE INSURANCE COMPANY | $14K | $0 | $14K | 9.43% |
| BLUE BACK, LLC3 Filed as: BLUE BACK LLC | 100 ALLYN STREET HARTFORD, CT 06103 | GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.31% |
| MICHAEL T REYES3 Filed as: MICHAEL K BROOKS | 190 STILL HILL RD HAMDEN, CT 06518 | AFLAC | $1K | $26 | $1K | 5.89% |
| BLUE BACK, LLC3 Filed as: BLUE BACK LLC | 100 ALLYN STREET SUITE 1 HARTFORD, CT 06103 | AFLAC | $642 | $0 | $642 | 3.28% |
| ALONZO L EDWARDS3 | 2390 STATE ST HOUSE #13 HAMDEN, CT 06517 | AFLAC | $196 | $0 | $196 | 1.00% |
| THOMAS P MCKIERNAN3 | 687 E BROADWAY MILFORD, CT 06460 | AFLAC | $184 | $0 | $184 | 0.94% |
| STEPHEN WEST3 Filed as: STEPHEN E WEST | 5 JANE ST BEACON FALLS, CT 06403 | AFLAC | $112 | $6 | $118 | 0.60% |
| MICHAEL REYES3 Filed as: MICHAEL R ROBERTS | 110 LIMERICK RD FAIRFIELD, CT 06824 | AFLAC | $103 | $0 | $103 | 0.53% |
| CHRISTOPHER M. MCKIERNAN3 Filed as: CHRISTOPHER M MCKIERNAN | 9 MARINO DR MILFORD, CT 06460 | AFLAC | $93 | $5 | $98 | 0.50% |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE RD 4TH FLR PHILADELPHIA, PA 19125 | AFLAC | $45 | $0 | $45 | 0.23% |
| JONATHAN THOMSON3 | 245 UNQUOWA RD APT 16 FAIRFIELD, CT 06824 | AFLAC | $17 | $0 | $17 | 0.09% |
| JOHN K SCHULE3 | 102 BLACKWOOD LN STAMFORD, CT 06903 | AFLAC | $16 | $0 | $16 | 0.08% |
| CHRISTOPHER S AUSTERMANN3 | 41 NEW LONDON TURNPIKE #B GLASTONBURY, CT 06033 | AFLAC | $13 | $0 | $13 | 0.07% |
| MICHAEL T REYES3 | 185 PLAINS RD STE 200E MILFORD, CT 06461 | AFLAC | $13 | $0 | $13 | 0.07% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | AFLAC | $12 | $0 | $12 | 0.06% |
| MARILENA K GREIG3 | 54 SAINT GEORGE LN NEW CANAAN, CT 06840 | AFLAC | $11 | $0 | $11 | 0.06% |
| JUSTIN GRIFFEY3 | 7 MICHELE DR CARLISLE, PA 17013 | AFLAC | $7 | $0 | $7 | 0.04% |
| CHRISTIAN PAUL VIRZI3 | 34 BLACK BEAR DR UNIT 1101 WALTHAM, MA 02451 | AFLAC | $2 | $0 | $2 | 0.01% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 198 | $32K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 242 | $144K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 242 | $144K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 242 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.