| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 060406910 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | — | $20K | 17.00% |
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 060406910 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | — | $15K | 17.00% |
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 06040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 11.56% |
| ROSEANN REYNOLDS3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $864 | $2K | 2.98% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFITS SERVICES INC. | 63 NORWICH AVENUE, SUITE 202 COLCHESTER, CT 06415 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.65% |
| KAREN PICCININI3 Filed as: KAREN ANN COYLE | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $418 | $2K | 2.02% |
| DAVID L FLEURY3 Filed as: DAVID FLEURY | 545 SOUTH MAIN STREET PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $572 | $371 | $943 | 1.21% |
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 060406910 | TRANSAMERICA | $28K | — | $28K | 43.36% |
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 060406910 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 060406910 | VISION SERVICE PLAN | $1K | — | $1K | 4.50% |
| HORACIO J. CABRAL3 | 30 LELAND DRIVE MANCHESTER, CT 060406910 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIVERSIFIED ADMINISTRATION CORP. EIN 06-0988547 NONE | Claims processing Service code 12 | — | $174K |
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 | 460 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 317 | $14K |
| Vision | VISION SERVICE PLAN | 201 | $33K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 460 | $86K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 292 | $117K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $87K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 294 | $131K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 539 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 539 | — |
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.