| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 35 WATERVIEW BOULEVARD, SUITE 300 PARSIPPANY, NJ 07054 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $9K | — | $9K | 3.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $743 | — | $743 | 0.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $24K | — | $24K | 10.69% |
| ADVANCED VOLUNTARY CONCEPTS INC3 Filed as: ADVANCED VOLUNTARY CONCEPTS, INC. | 75 SOUTH BROADWAY WHITE PLAINS, NY 10601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49K | — | $49K | 48.19% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 200 JEFFERSON OARK WHIPPANY, NJ 07981 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19K | — | $19K | 18.92% |
| TAMARA LYNN ALVES3 | 514 KISSAM ROAD PEEKSKILL, NY 10566 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.50% |
| GREAM M CLARK3 Filed as: GREAM M. CLARK | 589 WINDMERE DRIVE LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $709 | — | $709 | 0.70% |
| DONALD H MATSON3 Filed as: DONALD H. MATSON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $414 | $56 | $470 | 0.46% |
| THE CLARK GROUP OF SC3 | 589 WINDMERE DRIVE LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $461 | — | $461 | 0.45% |
| MJ INSURANCE3 Filed as: ADVANCED BENEFIT AND VARIOUS AGENTS | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.04% |
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 | 238 | 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) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 499 | $247K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 499 | $247K |
| Life insurance | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | 238 | $221K |
| Short-term disability | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | 238 | $221K |
| Long-term disability | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | 238 | $221K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | 238 | $322K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 499 | — |
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.