| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN KAUFMAN | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $95K | $4K | $99K | 13.43% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFITS GROUP INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $59K | $59K | 8.06% |
| KEITH LEPACK3 Filed as: KEITH J BELL | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $39 | — | $39 | 0.01% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN KAUFMAN | 31 HATHEWAY DRIVE HARTFORD, CT 06107 | METROPOLITAN LIFE INSURANCE COMPANY | $22K | — | $22K | 14.10% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC | 2 ENTERPRISE DRIVE SUITE 204 SHELTON, CT 06484 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 5.05% |
| JOHN M KAUFMAN3 | 20 BATTERSON PARK ROAD #12R FARMINGTON, CT 06032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.69% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| JOHN M KAUFMAN3 | 20 BATTERSON PARK ROAD #12R FARMINGTON, CT 06032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.83% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| UNITED OF OMAHA LIFE INSURANCE CO3 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | — |
| JOHN M KAUFMAN3 | 20 BATTERSON PARK ROAD #12R FARMINGTON, CT 06032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $617 | — | $617 | — |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $309 | $309 | — |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 413 | $159K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 413 | $159K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $41K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $34K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 174 | $737K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 413 | — |
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.