| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $26K | $32K | 2.84% |
| BRENDA K COX3 Filed as: BRENDA K. COX | 1039 SPRINGWAY DRIVE SHELBYVILLE, IN 46176 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 7.49% |
| HOWARD MESZAROS3 | 8680 COLVIN DRIVE PLAIN CITY, OH 43064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $451 | $0 | $451 | 1.22% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $255 | $20 | $275 | 0.74% |
| DIANA GILLESPIE3 | 353 EXCEL LANE MOGADORE, OH 44260 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $59 | $0 | $59 | 0.16% |
| BEYLAND CONSULTANTS INC3 Filed as: BEYLAND CONSULTANTS LLC | 519 WINDSOR PARK DRIVE CENTERVILLE, OH 45459 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $43 | $0 | $43 | 0.12% |
| DAVID L SMELCER3 Filed as: DAVID LEE SMELCER AND OTHER AGENTS | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.08% |
| TODD J STRBIK3 Filed as: TODD J. STRBIK | 1727 NEMOKE TRAIL 4 HASLETT, MI 48840 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 11.58% |
| THOMAS SCANLON3 | 121 ROLLING MEADOW DRIVE HOLLISTON, MA 01746 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $82 | $3K | 11.21% |
| MELISSA J LINDSEY3 Filed as: MELISSA J. LINDSEY | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $288 | $0 | $288 | 1.16% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK ROAD SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $174 | $84 | $258 | 1.04% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $0 | $126 | 0.51% |
| MICHAEL R ACKERMAN3 Filed as: MICHAEL R. ACKERMAN | 435 DEVON PARK DRIVE WAYNE, PA 19087 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $0 | $126 | 0.51% |
| FLEURY ENTERPRISES INC3 Filed as: FLEURY ENTERPRISES, INC. | 162 INDIAN POINT ROAD TIVERTON, RI 02878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.12% |
| FALVEY BENEFIT ADVISORS INC3 Filed as: FALVEY BENEFIT ADVISORS INC. | 2 LOCUST HILL DRIVE MENDON, MA 01756 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.12% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.54% |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $1.1M |
| Vision | VISION SERVICE PLAN | 103 | $19K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 205 | $92K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 205 | $30K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $1.1M |
| Other | ANTHEM LIFE INSURANCE COMPANY | 205 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.