| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INSURANCE, LLC | 68 NATIONAL DRIVE #E GLASTONBURY, CT 06033 | ANTHEM HEALTH PLANS, INC. | $27K | — | $27K | 3.29% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 N 40TH ST. STE 234 PHOENIX, AZ 85018 | ANTHEM HEALTH PLANS, INC. | — | $15K | $15K | 1.85% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INSURANCE, LLC | 68 NATIONAL DR. GLASTONBURY, CT 06033 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 7.25% |
| CFS HARTFORD LLC3 | 197 SCOTT SWAMP ROAD FARMINGTON, CT 06032 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $53 | — | $53 | 0.08% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | PO BOX 299 MARLBOROUGH, CT 06447 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 24.94% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INSURANCE, LLC | 68 NATIONAL DR. STE 2 GLASTONBURY, CT 06033 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $449 | $3K | 27.22% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | PO BOX 299 MARLBOROUGH, CT 06447 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 25.14% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS, INC. | 144 | $815K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 67 | $63K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 67 | $63K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $10K |
| Other(3 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 110 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.
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.