| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $2K | $180 | $2K | 6.56% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $467 | — | $467 | 1.47% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $390 | — | $390 | 1.23% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $368 | — | $368 | 1.16% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $347 | — | $347 | 1.09% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $163 | $38 | $201 | 0.63% |
| DOUGLAS CAPAZZI3 | 215 ROPE FERRY ROAD WATERFORD, CT 06385 | AFLAC | $67 | $48 | $115 | 0.36% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $88 | — | $88 | 0.28% |
| TYLER GRACEY3 | 22 MINER LANE, UNIT B10 WATERFORD, CT 06385 | AFLAC | $85 | — | $85 | 0.27% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | EACH PAID UNDER 18 GLASTONBURY, CT 06033 | AFLAC | $79 | — | $79 | 0.25% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $2K | $260 | $3K | 9.05% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $757 | — | $757 | 2.72% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $437 | — | $437 | 1.57% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $370 | $48 | $418 | 1.50% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $383 | — | $383 | 1.38% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $380 | — | $380 | 1.37% |
| CHRISTIAN VIRZI3 | 25 HIGH STREET, APT. 3C MILFORD, CT 06460 | AFLAC | $148 | — | $148 | 0.53% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | EACH PAID UNDER 18 CRANSTON, RI 02905 | AFLAC | $53 | $27 | $80 | 0.29% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $64 | — | $64 | 0.23% |
| RICE, DAVIS, DAILEY AND KRENZ, INC.3 | 50 WASHINGTON STREET MIDDLETOWN, CT 06457 | AFLAC | $23 | — | $23 | 0.08% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | HCC LIFE INSURANCE COMPANY | $549 | — | $549 | 3.00% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $1K | $60 | $1K | 8.18% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $544 | — | $544 | 3.25% |
| CHRISTIAN VIRZI3 | 25 HIGH STREET, APT. 3C MILFORD, CT 06460 | AFLAC | $241 | — | $241 | 1.44% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $203 | $10 | $213 | 1.27% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $185 | — | $185 | 1.11% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $140 | — | $140 | 0.84% |
| KAREN BUCK3 | 71 DEEPWOOD DRIVE MADISON, CT 06443 | AFLAC | $111 | $16 | $127 | 0.76% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $118 | — | $118 | 0.71% |
| TYLER GRACEY3 | 22 MINER LANE, UNIT B10 WATERFORD, CT 06385 | AFLAC | $95 | — | $95 | 0.57% |
| STEPHEN WEST3 | 5 JANE STREET BEACON FALLS, CT 06403 | AFLAC | $55 | $6 | $61 | 0.36% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $34 | — | $34 | 0.20% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | EACH PAID UNDER 18 MADISON, CT 06443 | AFLAC | $19 | — | $19 | 0.11% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $708 | $70 | $778 | 5.17% |
| GREGORY LAFLAM3 | 894 PUCKER STREET COVENTRY, CT 06238 | AFLAC | $367 | — | $367 | 2.44% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $202 | — | $202 | 1.34% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $184 | — | $184 | 1.22% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $139 | — | $139 | 0.92% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $135 | — | $135 | 0.90% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $85 | — | $85 | 0.57% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $60 | $12 | $72 | 0.48% |
| CHRISTIAN VIRZI3 | 25 HIGH STREET, APT. 3C MILFORD, CT 06460 | AFLAC | $29 | — | $29 | 0.19% |
| TYLER GRACEY3 | 22 MINER LANE, UNIT B10 WATERFORD, CT 06385 | AFLAC | $28 | — | $28 | 0.19% |
| JOHN K SCHULE3 Filed as: JOHN SHULE | 102 BLACKWOOD LN STAMFORD, CT 06903 | AFLAC | $16 | — | $16 | 0.11% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $1K | $28 | $1K | 8.78% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $413 | — | $413 | 3.49% |
| CHRISTIAN VIRZI3 | 25 HIGH STREET, APT. 3C MILFORD, CT 06460 | AFLAC | $168 | $7 | $175 | 1.48% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $139 | — | $139 | 1.18% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $121 | $7 | $128 | 1.08% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $115 | — | $115 | 0.97% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $91 | — | $91 | 0.77% |
| TYLER GRACEY3 | 22 MINER LANE, UNIT B10 WATERFORD, CT 06385 | AFLAC | $58 | — | $58 | 0.49% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $35 | — | $35 | 0.30% |
| AMBER PERSOHN3 | 39W436 LONG MEADOW LANE SAINT CHARLES, IL 60175 | AFLAC | $25 | — | $25 | 0.21% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | EACH PAID UNDER 18 NORWICH, CT 06360 | AFLAC | $16 | — | $16 | 0.14% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $802 | $93 | $895 | 10.35% |
| DOUGLAS CAPAZZI3 | 215 ROPE FERRY ROAD WATERFORD, CT 06385 | AFLAC | $198 | $45 | $243 | 2.81% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $218 | — | $218 | 2.52% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $207 | — | $207 | 2.39% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $150 | $25 | $175 | 2.02% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $162 | — | $162 | 1.87% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $75 | — | $75 | 0.87% |
| TYLER GRACEY3 | 22 MINER LANE, UNIT B10 WATERFORD, CT 06385 | AFLAC | $53 | — | $53 | 0.61% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $29 | — | $29 | 0.34% |
| JOHN K SCHULE3 Filed as: JOHN SCHULE | 102 BLACKWOOD LANE STAMFORD, CT 06903 | AFLAC | $5 | — | $5 | 0.06% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $281 | $24 | $305 | 4.22% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $226 | — | $226 | 3.13% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $162 | — | $162 | 2.24% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $91 | — | $91 | 1.26% |
| MICHAEL REYES3 | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $58 | — | $58 | 0.80% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | EACH PAID UNDER 18 SOUTH GLASTONBURY, CT 06033 | AFLAC | $50 | — | $50 | 0.69% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $31 | $4 | $35 | 0.48% |
| GRACEY BENEFIT SOLUTIONS, LLC3 | 80 NORWICH NEW LONDON TPKE., STE. M UNCASVILLE, CT 06382 | AFLAC | $387 | $6 | $393 | 8.71% |
| MARY JANE SULLIVAN3 | P.O. BOX 306 SOUTH GLASTONBURY, CT 06073 | AFLAC | $197 | — | $197 | 4.37% |
| CHRISTIAN VIRZI3 | 25 HIGH STREET, APT. 3C MILFORD, CT 06460 | AFLAC | $74 | — | $74 | 1.64% |
| CHRISTOPHER S AUSTERMANN3 Filed as: CHRISTOPHER S. AUSTERMANN | 148 EASTERN BOULEVARD GLASTONBURY, CT 06033 | AFLAC | $60 | $3 | $63 | 1.40% |
| DAVID SULLIVAN3 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | AFLAC | $51 | — | $51 | 1.13% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $47 | — | $47 | 1.04% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | AFLAC | $37 | — | $37 | 0.82% |
| TYLER GRACEY3 | 22 MINER LANE, UNIT B10 WATERFORD, CT 06385 | AFLAC | $35 | — | $35 | 0.78% |
| DOUGLAS CAPAZZI3 | 215 ROPE FERRY ROAD WATERFORD, CT 06385 | AFLAC | $13 | $13 | $26 | 0.58% |
| DIVERSIFIED GROUP BROKERAGE CORP.3 | P.O. BOX 299 MARLBOROUGH, CT 06447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $887 | — | $887 | 25.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIVERSIFIED ADMINISTRATION CORP. EIN 06-0988547 NONE | Claims processing Service code 12 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | $176K |
| CORPORATE MANAGED HEALTH SERVICES EIN 06-1421429 NONE | Contract Administrator Service code 13 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | $38K |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(9 contracts, 2 carriers) | AFLAC | 270 | $127K |
| Short-term disability(9 contracts, 2 carriers) | AFLAC | 270 | $127K |
| Stop-loss / reinsurancereinsurance | US FIRE INSURANCE COMPANY | 124 | $375K |
| Other(10 contracts, 3 carriers) | AFLAC | 270 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.