| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES, INC. | 30 CORPORATE DRIVE CLIFTON PARK, NC 12065 | EMPIRE HEALTHCHOICE ASSURANCE INC | $29K | — | $29K | 1.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC - 200 | W CYPRESS CREEK ROAD #500 FORT LAUDERDALE, FL 33309 | EMPIRE HEALTHCHOICE ASSURANCE INC | $27K | $1K | $29K | 1.10% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES, INC. | 30 CORPORATE DRIVE CLIFTON PARK, NY 12065 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | — | $4K | 4.30% |
| USI INSURANCE SERVICES LLC3 | P O BOX 20138 ATLANTA, GA 30325 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $182 | $3K | 3.03% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES, INC. | 30 CORPORATE DRIVE CLIFTON PARK, NY 12065 | GUARDIAN | $2K | — | $2K | 11.19% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD NE SUITE 800 ATLANTA, GA 30305 | AFLAC | $628 | — | $628 | 3.66% |
| JENNIFER F HENDRICKS-FOGG3 | 413 GLEN AVENUE SCOTIA, NC 12302 | AFLAC | $269 | — | $269 | 1.57% |
| JOSEPH B NEYLAND3 | 3985 MANOR HOUSE DRIVE MARIETTA, GA 30062 | AFLAC | $258 | — | $258 | 1.50% |
| ANGELA MONTENEGRO3 | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $95 | — | $95 | 0.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: PAUL B WILLIS | 2541 HYDE MANOR DR NW ATLANTA, GA 30327 | AFLAC | $92 | — | $92 | 0.54% |
| THOMAS DOWNS3 | 122 VIEWPOINT TERRACE PEEKSKILL, NY 10566 | AFLAC | $73 | — | $73 | 0.43% |
| JOSHUA K HOPPE3 | 85076 MAJESTIC WALK CIRCLE FERNANDINA BEACH, FL 32034 | AFLAC | $73 | — | $73 | 0.43% |
| MELISSA ANN STEWART3 | 36 WINCOMA LANE QUEENSBURY, NY 12804 | AFLAC | $47 | $14 | $61 | 0.36% |
| ROGER JONES II3 Filed as: ROGER JONES | 2204 COMMERCE STREET ALPHARETTA, GA 30009 | AFLAC | $43 | — | $43 | 0.25% |
| SCOTT A SMITH3 | 5300 OAKBROOK PARKWAY SUITE 300 NORCROSS, GA 30093 | AFLAC | $4 | — | $4 | 0.02% |
| STEVEN VORDERLANDWEHR3 | 1599 AMHEARST MILL DRIVE LAWRENCEVILLE, GA 30043 | AFLAC | $4 | — | $4 | 0.02% |
| DUSTIN ROBERT JOHNSON3 | 745 W BROMPTON AVENUE APT 1 CHICAGO, IL 60657 | AFLAC | $2 | — | $2 | 0.01% |
| DUSTIN ROBERT JOHNSON3 | 50 HURT PLAZA SE SUITE 995 ATLANTA, GA 30303 | AFLAC | $2 | — | $2 | 0.01% |
| JOSEPH B NEYLAND3 | 3985 MANOR HOUSE DRIVE MARIETTA, GU 30062 | AFLAC | $83 | — | $83 | 4.57% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD NE SUITE 800 ATLANTA, GA 30305 | AFLAC | $31 | — | $31 | 1.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 CLAIMS ADMIN | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | 9 PINE STREET 14TH FLOOR NEW YORK, NY 10005 | $7K |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC | 314 | $2.6M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE INC | 314 | $2.6M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE INC | 314 | $2.6M |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 155 | $106K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 155 | $106K |
| Long-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 155 | $106K |
| Other(4 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 155 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.