| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: COOL INSURING AGENCY INC. | 784 TROY-SCHENECTADY ROAD LATHAM, NY 12110 | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC. | $45K | $0 | $45K | 3.49% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES INC. | 30 CORPORATE DRIVE CLIFTON PARK, NY 120658603 | COMPANION LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| FRANCES LYNN MCCARTER3 | 10331 LINKSLAND DR HUNTERSVILLE, NC 28078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2 | $1K | 8.45% |
| DAVID D UNDERWOOD3 | PO BOX 32694 CHARLOTTE, NC 28232 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $830 | $225 | $1K | 8.01% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE INC | 419 WHITESTONE ROAD CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $850 | $0 | $850 | 6.46% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DRIVE WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $100 | $234 | 1.78% |
| PHIL COLEMAN3 | 18908 RIVERWIND LN DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $167 | $0 | $167 | 1.27% |
| LEON MARTIN3 | 1520 MARTIN STREET WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | $0 | $52 | 0.39% |
| MICHELSEN BENEFITS GROUP, INC.3 Filed as: MICHELSEN BENEFITS GROUP INC | 419 WHITESTONE ROAD CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $0 | $46 | 0.35% |
| UN HUI SMITH3 | PO BOX 1722 DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.05% |
| JOHN L MORRIS3 | 117 ALLISON STREET FORT MILL, SC 29715 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.02% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES INC. | 30 CORPORATE DRIVE CLIFTON PARK, NY 120658603 | COMPANION LIFE INSURANCE COMPANY | $902 | $0 | $902 | 10.00% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES INC. | 30 CORPORATE DR CLIFTON PARK, NY 12065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $497 | $0 | $497 | 9.34% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES INC. | 30 CORPORATE DRIVE CLIFTON PARK, NY 120658603 | MUTUAL OF OMAHA INSURANCE COMPANY | $200 | $0 | $200 | 9.98% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES INC. | 30 CORPORATE DRIVE CLIFTON PARK, NY 120658603 | MUTUAL OF OMAHA INSURANCE COMPANY | $58 | $0 | $58 | 10.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 | Other fees; Claims processing Service code 12 | — | $11K |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC. | 192 | $1.4M |
| Life insurance(4 contracts, 3 carriers) | COMPANION LIFE INSURANCE COMPANY | 165 | $46K |
| Prescription drug | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC. | 192 | $1.3M |
| Other(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 165 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.