| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $28K | $28K | 7.12% |
| PROFESSIONAL PENSIONS INC5 Filed as: PROFESSIONAL PENSIONS, INC. | 10 RESEARCH PARKWAY WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.14% |
| MICHELE J ZRELAK3 Filed as: MICHELE J. ZRELAK | 8 MULLER DRIVE NEW CITY, NY 10956 | AFLAC | $2K | $15 | $2K | 6.30% |
| LYNETTE J. DARK & OTHER AGENTS3 | 141 CORKWOOD BOULEVARD HOMOSASSA, FL 34446 | AFLAC | $1K | $35 | $1K | 4.62% |
| LISA M WYLIE3 Filed as: LISA MARIE WYLIE | 55 HARVARD AVENUE, APARTMENT 123 HYDE PARK, MA 02136 | AFLAC | $506 | $0 | $506 | 1.77% |
| VINCENT KRILL3 Filed as: VINCENT J. KRILL | 225 DOLSON AVENUE, SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $307 | $9 | $316 | 1.10% |
| ERIN BRZOZOWSKI, INC.3 | 2 LIBERTY DRIVE LEMONT, IL 60439 | AFLAC | $196 | $0 | $196 | 0.68% |
| R SERAPHIM WOOD3 Filed as: R. SERAPHIM WOOD | 36 COOPER ROAD MONROE, NY 10950 | AFLAC | $170 | $0 | $170 | 0.59% |
| ANNE CASSIDY3 Filed as: ANNE E. CASSIDY | 354 OVERTURE WAY CENTREVILLE, MD 21617 | AFLAC | $134 | $0 | $134 | 0.47% |
| VINCENT J. KRILL & OTHER AGENTS3 | 225 DOLSON AVENUE, SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $380 | $0 | $380 | 4.09% |
| LISA M WYLIE3 Filed as: LISA MARIE WYLIE | 55 HARVARD AVENUE, APARTMENT 123 HYDE PARK, MA 02136 | AFLAC | $134 | $0 | $134 | 1.44% |
| MICHELE J ZRELAK3 Filed as: MICHELE J. ZRELAK | 8 MULLER DRIVE NEW CITY, NY 10956 | AFLAC | $128 | $0 | $128 | 1.38% |
| STEVEN R. BACHUSS3 | 3899 LEACH ROAD SNELLVILLE, GA 30039 | AFLAC | $110 | $0 | $110 | 1.18% |
| ANNE CASSIDY3 Filed as: ANNE E. CASSIDY | 354 OVERTURE WAY CENTREVILLE, MD 21617 | AFLAC | $98 | $0 | $98 | 1.06% |
| DONNA N THOMAS3 Filed as: DONNA N. THOMAS | 71 MONTROSE LANE SHARPSBURG, GA 30277 | AFLAC | $88 | $0 | $88 | 0.95% |
| ERIN BRZOZOWSKI, INC.3 | 2 LIBERTY DRIVE LEMONT, IL 60439 | AFLAC | $75 | $0 | $75 | 0.81% |
| MICHELE J ZRELAK3 Filed as: MICHELE J. ZRELAK | 8 MULLER DRIVE NEW CITY, NY 10956 | AFLAC | $217 | $0 | $217 | 5.67% |
| RICHARD WHWLAN & OTHER AGENTS3 | 3887 NW 52ND STREET BOCA RATON, FL 33496 | AFLAC | $102 | $5 | $107 | 2.79% |
| LISA M WYLIE3 Filed as: LISA MARIE WYLIE | 55 HARVARD AVENUE, APARTMENT 123 HYDE PARK, MA 02136 | AFLAC | $70 | $0 | $70 | 1.83% |
| VINCENT KRILL3 Filed as: VINCENT J. KRILL | 225 DOLSON AVENUE, SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $49 | $0 | $49 | 1.28% |
| ALVARO JAVIER MONTENEGRO3 | 5 ELYSE DRIVE NEW CITY, NY 10956 | AFLAC | $30 | $0 | $30 | 0.78% |
| DYLAN FRANCIS MONTEFORTE3 | 61 DESAI COURT FREEHOLD, NJ 07728 | AFLAC | $29 | $0 | $29 | 0.76% |
| MICHAEL T REYES3 Filed as: MICHAEL T. REYES | 185 PLAINS ROAD, SUITE 200E MILFORD, CT 06461 | AFLAC | $28 | $0 | $28 | 0.73% |
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 | 537 | 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) | 537 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 780 | $460K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 780 | $419K |
| Life insurance(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 537 | $439K |
| Short-term disability(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 537 | $439K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 537 | $397K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 537 | $439K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 780 | — |
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.