| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERRIDITH STANTON3 | 21 GUILFORD PLACE BURLINGTON TWP, NJ 08016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24K | $9K | $33K | 12.33% |
| LISA A PERRI3 | 775 ROUTE 70 EAST MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19K | $4K | $23K | 8.63% |
| MICHAEL J PERRI3 Filed as: MICHAEL J. PERRI | 775 ROUTE 70 EAST MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1K | $6K | 2.30% |
| MELISSA VOSMUS LYON3 | 257 SANDPIPER DRIVE CASSELBERRY, FL 32707 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.42% |
| JILL R LAMBERT3 Filed as: JILL DICE-MALGIER | 17 MIDBRIDGE DRIVE MEDFORD, NJ 08055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $811 | $145 | $956 | 0.36% |
| STEVIE KIRCHER3 | 1371 ORIENTAL AVE GLOUCESTER CITY, NJ 08030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $853 | $67 | $920 | 0.35% |
| THELMA LOUISE WIGGINS3 | 115 CAMLIN COURT COLUMBIA, SC 29229 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $262 | $79 | $341 | 0.13% |
| DONALD B FAULKNER SR3 Filed as: DONALD B. FAULKNER SR. | 612 IVY GREEN LANE IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $290 | $6 | $296 | 0.11% |
| KAREN PICCININI3 | 425 W COLONIAL DRIVE ORLANDO, FL 32804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $168 | $39 | $207 | 0.08% |
| TAYLOR LEIGH PERRI3 | 775 EAST ROUTE 70 MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | $51 | $117 | 0.04% |
| KIM REED SMITH3 Filed as: KIM HAIST | 803 RALSTON DRIVE MOUNT LAUREL, NJ 08054 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $0 | $88 | 0.03% |
| JESSIE R CAPLEY3 Filed as: JESSIE R. CAPLEY | 1716 STILLWATER DRIVE COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | $19 | $86 | 0.03% |
| ADVANCED BENEFIT SYSTEM INC Filed as: ADVANCED BENEFIT SYSTEM INC. | 1301 FERVAIS STREET COLUMBIA, SC 29201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $53 | $84 | 0.03% |
| TERRY J SILVERS3 Filed as: TERRY D. GARRETT | 459 RUNNING FOX ROAD WEST COLUMBIA, SC 29223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | $10 | $53 | 0.02% |
| SHEALY BENEFITS SERVICES INC3 Filed as: SHEALY BENEFITS SERVICES INC. | 215 HOGAN WAY LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $22 | $47 | 0.02% |
| ROMEO TYRONE GAINEY3 | 1343 PARLIAMENT LAKE DRIVE COLUMBIA, SC 29223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $3 | $23 | 0.01% |
| JASON R JONES3 | 3706 PALM ROAD LAKELAND, FL 33810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.01% |
| HOBART BRADLEY MCCOLLUM3 | 1479 FIRE TOWER ROAD PROSPERITY, SC 29127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $6 | $11 | 0.00% |
| CIEMONE SHEPPARD3 | 11 MOSSHILL LANE WILLINGBORO, NJ 08846 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.00% |
| NANCY BENNETT & ASSOCIATES INC3 Filed as: NANCY BENNETT & ASSOCIATES, INC. | P.O. BOX 421645 KISSIMMEE, FL 34742 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.00% |
| NORTH AMERICAN BENEFITS COMPANY5 | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | $0 | $9K | $9K | 16.50% |
| ARTHUR COX WILSON & ASSOCIATES3 | 18 MYSTIC LANE MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.44% |
| ECBM LP3 Filed as: ECBM | 300 CONSHOCKEN STATE ROAD STE. 405 WEST CONSHOHOCKEN, PA 19428 | MADISON NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.44% |
| ARTHUR COX WILSON & ASSOCIATES3 | 18 MYSTIC LANE MALVERN, PA 19355 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.63% |
| ECBM LP3 | 300 CONSHOHOCKEN STATE ROAD SUITE 405 WEST CONSHOHOCKEN, PA 19428 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.63% |
| BROKERAGE CONCEPTS INC3 Filed as: BROKERAGE CONCEPTS, INC. | P.O. BOX 742 BLUE BELL, PA 19422 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.00% |
| ARTHUR COX WILSON & ASSOCIATES3 | 18 MYSTIC LANE MALVERN, PA 193551942 | AMERITAS LIFE INSURANCE CORP. | $938 | $0 | $938 | 3.11% |
| ECBM LP3 | 300 CONSHOHOCKEN STATE ROAD SUITE 405 WEST CONSHOHOCKEN, PA 19428 | AMERITAS LIFE INSURANCE CORP. | $938 | $0 | $938 | 3.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 NONE | Plan Administrator; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | — | $79K |
| CIGNA EIN 59-1031071 NONE | Plan Administrator; Claims processing; Other services Service code 12 | — | $46K |
| ARTHUR COX WILSON & ASSOCIATES EIN 23-2230858 NONE | Consulting (general); Insurance brokerage commissions and fees; Insurance agents and brokers Service code 16 | — | $15K |
| ECBM EIN 43-2071188 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Consulting (general) Service code 16 | — | $15K |
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 | 301 | 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) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP. | 187 | $30K |
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 381 | $51K |
| Short-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 114 | $53K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 381 | $51K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 381 | $315K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 381 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.