| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 COLLEGE PARK, GA 30349 | AETNA LIFE INSURANCE COMPANY | $157K | $2K | $159K | 2.62% |
| LOCKTON COMPANIES, LLC3 | 3280 PEACHTREE ROAD NE, SUITE 800 ATLANTA, GA 30305 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | $4K | $21K | 7.42% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $79 | $79 | 0.03% |
| IVAN M SERVAIS3 Filed as: IVAN M. SERVAIS AND OTHER AGENTS | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $1K | $0 | $1K | 3.91% |
| KEITH LEPACK3 | 1991 BROADWAY, APARTMENT 12B NEW YORK, NY 10023 | AFLAC | $1K | $0 | $1K | 3.43% |
| BRETT G. DIAMOND3 | 4 DEVONSHIRE WAY HALFMOON, NY 12065 | AFLAC | $639 | $0 | $639 | 1.78% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | 2 PARK AVENUE, 20TH FLOOR NEW YORK, NY 10016 | AFLAC | $500 | $0 | $500 | 1.39% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES BURNS | 11 OVERHILL ROAD FAIRFIELD, CT 06824 | AFLAC | $210 | $0 | $210 | 0.58% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | 2 RIVERSIDE DRIVE, SUITE 200 CAMDEN, NJ 08103 | AFLAC | $206 | $0 | $206 | 0.57% |
| STEPHEN WHITE3 Filed as: STEPHEN P. WHITE | 5 EMERALD LANE MONTEBELLO, NY 10901 | AFLAC | $177 | $0 | $177 | 0.49% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.43% |
| KEITH LEPACK3 | 1991 BROADWAY, APARTMENT 12B NEW YORK, NY 10023 | AFLAC | $531 | $0 | $531 | 9.31% |
| KIMMON R GUSEMAN3 Filed as: KIMMON R. GUSEMAN AND OTHER AGENTS | 47 EAST FAYETTE STREET, UNIT 259 UNIONTOWN, PA 15401 | AFLAC | $66 | $0 | $66 | 1.16% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $59 | $0 | $59 | 1.03% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | 2 RIVERSIDE DRIVE, SUITE 200 CAMDEN, NJ 08103 | AFLAC | $35 | $0 | $35 | 0.61% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | 12 COURTNEY LANE BREWSTER, NY 10509 | AFLAC | $31 | $0 | $31 | 0.54% |
| RICHARD WHELAN3 | 3887 NW 52ND STREET BOCA RATON, FL 33496 | AFLAC | $14 | $0 | $14 | 0.25% |
| TREVOR FENNELL3 Filed as: TREVOR R. FENNELL | 7 HIGHLAND LANE EAST HAMPTON, NY 11937 | AFLAC | $13 | $0 | $13 | 0.23% |
| RCM AND D3 Filed as: RCM&D, INC. | 555 FAIRMOUNT AVENUE BALTIMORE, MD 21286 | ZURICH AMERICAN INSURANCE COMPANY | $218 | $0 | $218 | 15.03% |
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 | 360 | 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) | 360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 575 | $6.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 575 | $6.1M |
| Vision | VISION SERVICE PLAN | 260 | $34K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 359 | $277K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 359 | $277K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 359 | $277K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 575 | $6.1M |
| Other(4 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 360 | $320K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.