| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | 2340 S DES PLAINES RIVER ROAD SUITE 303 DES PLAINES, IL 60018 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $113K | $113K | 2.52% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SRVS. | 800 MAIN STREET DUBUQUE, IA 520040028 | DELTA DENTAL OF NEW JERSEY, INC. | $39K | — | $39K | 9.98% |
| JBN BENEFITS CONSULTANTS LLC3 | 290 W MOUNT PLEASANT AVE STE 2300 LIVINGSTON, NJ 07039 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $35K | — | $35K | 10.78% |
| MSM GENERAL AGENCY INC3 | 2300 HYLAND BLVD. STE 2 STATEN ISLAND, NY 10306 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | — | $17K | 5.31% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS | 800 MAIN ST DUBUQUE, IA 52001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29K | — | $29K | 12.44% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DRIVE APPLETON, WI 54914 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | $6K | $19K | 8.18% |
| DANIEL FROST3 | 241 POYGAN RD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15K | $2K | $17K | 7.32% |
| MAYNARD IRVIN HEBERT II3 | 106 CUMBERLYNN DR FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 2.78% |
| RODNEY JAMES SONNENBERG3 | 432 AMORY ST FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $581 | $70 | $651 | 0.28% |
| ADAM J ZAHN3 | 725 E GRANT STREET APPLETON, WI 54911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $531 | $33 | $564 | 0.24% |
| ROSE RODRIQUEZ CUEVAS3 | 1675 S FRANKWOOD AVE REEDLEY, CA 93654 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $508 | $3 | $511 | 0.22% |
| HELEN DIZ-HATTON3 | 4 PALMER LN ENGLISHTOWN, NJ 07726 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $189 | — | $189 | 0.08% |
| THERESA NETTO PHILLIPS3 | 6219 S CLARA FRESNO, CA 93706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $1 | $62 | 0.03% |
| BARRY W MAAS3 | 1272 W. MORAGA RD FRESNO, CA 93711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $2 | $35 | 0.01% |
| MORGAN PERRI3 | 23 VOM EIGEN DR MORRISTOWN, NJ 07960 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| LAURIE J BURNS3 | 15 CEDARS EDGE CT BLUFFTON, SC 29910 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| WENDY ELIZABETH WESOLOWSKI3 | 1284 N 12TH AVE PENSACOLA, FL 32503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| PAUL STANLEY JR3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INS BENEFITS INC | 9085 BETHEL RD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| NORMAC SOLUTIONS INC3 | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CHRISTINE L COURTNEY3 | 24392 OAKWOOD PARK RD ST. MICHAELS, MD 21663 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | 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% |
| SALATHIEL MALDONADO3 | 3717 CYPRESS AVE BROOKLYN, NY 11224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MICHAEL GEOFFREY VASQUEZ3 | 451 EMERSON DR AMHERST, NY 14226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROBERT JAY WEINER3 | 117 WEST 96TH ST NEW YORK, NY 10025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52004 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | — | $5K | 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 | 530 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 534 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 360 | $5.6M |
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 908 | $389K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 840 | $72K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $328K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $328K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $328K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $563K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 908 | — |
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."
No prospect flags tripped on this filing.