| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $67K | $67K | 2.62% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | 800 MAIN STREET DUBUQUE, IA 52001 | DELTA DENTAL OF NEW JERSEY, INC. | $27K | — | $27K | 9.99% |
| JBN BENEFITS CONSULTANTS LLC3 | 290 W MOUNT PLEASANT AVE STE 2300 LIVINGSTON, NJ 07039 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | — | $24K | 10.84% |
| MSM GENERAL AGENCY INC3 Filed as: MSM GENERAL AGENCY | 2300 HYLAND BLVD. STE 2 STATEN ISLAND, NY 10306 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | — | $12K | 5.34% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS | 800 MAIN ST DUBUQUE, IA 52001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15K | — | $15K | 9.70% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DRIVE APPLETON, WI 54914 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $2K | $10K | 6.20% |
| DANIEL FROST3 | 241 POYGAN RD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $252 | $7K | 4.36% |
| MAYNARD IRVIN HEBERT II3 | 106 CUMBERLYNN DR FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $468 | $3K | 1.60% |
| RODNEY JAMES SONNENBERG3 | 432 AMORY ST FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $69 | $1K | 0.70% |
| ROSE RODRIQUEZ CUEVAS3 | 1675 S FRANKWOOD AVE REEDLEY, CA 93654 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $834 | $17 | $851 | 0.54% |
| ADAM J ZAHN3 | 507 MAPLE RIDGE CT BLACK CREEK, WI 54106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $468 | $20 | $488 | 0.31% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $427 | — | $427 | 0.27% |
| HELEN DIZ-HATTON3 | 4 PALMER LANE ENGLISHTOWN, NJ 07726 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $229 | — | $229 | 0.14% |
| THERESA NETTO PHILLIPS3 | 6219 S CLARA FRESNO, CA 93706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | $4 | $97 | 0.06% |
| BARRY W MAAS3 | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $8 | $69 | 0.04% |
| WENDY ELIZABETH WESOLOWSKI3 | 1284 N 12TH AVE PENSACOLA, FL 32503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.02% |
| LORI ANN BURNS3 | 1558 NORTH OXFORD AVE CLOVIS, CA 93654 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.02% |
| MORGAN PERRI3 | 40 LEXINGTON CIR MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| LAURIE J BURNS3 | 15 CEDARS EDGE CT BLUFFTON, SC 29910 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| PAUL STANLEY JR3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $1 | $11 | 0.01% |
| JOHN ANTHONY PERNICE3 | 2361 NORTH 88TH ST WAUWATOSA, WI 53226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| ROBERT JAY WEINER3 | 117 WEST 96TH ST NEW YORK, NY 10025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| MICHAEL GEOFFREY VASQUEZ3 | 451 EMERSON DR AMHERST, NY 14226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| CHRISTINE L COURTNEY3 | 333 WEEKSRIDGE LN MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL RD GAINSVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DR MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| GARSON FINANCIAL SERVICES S C3 | 904 E PEARSON STREET MILWAUKEE, WI 53202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| SALATHIEL MALDONADO3 | 3717 CYPRESS AVE BROOKLYN, NY 11224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| LISA A PERRI3 | 775 ROUTE 70 EAST MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 7.00% |
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 | 415 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 418 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 232 | $3.5M |
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 376 | $265K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 326 | $45K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 426 | $223K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 426 | $223K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 426 | $223K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 426 | $382K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.