| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | AETNA LIFE INSURANCE CO. | $5K | $0 | $5K | 4.48% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC SAN FRAN | 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $4K | 5.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1285 DRUMMERS LN STE 305 WAYNE, PA 19087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.95% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST 6TH FLOOR SAN DIEGO, CA 92101 | UNION SECURITY INSURANCE COMPANY | — | $0 | $0 | 0.00% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK RD ORADELL, NJ 07649 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 29.16% |
| ALLIANCE INSURANCE GROUP LLC3 Filed as: ALLIANCE INSURANCE SERVICES | 1125 SANCTUARY PARKWAY ALPHARETTA, GA 30009 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 19.41% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC SAN FRAN | 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $586 | $493 | $1K | 9.35% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1285 DRUMMERS LN STE 305 WAYNE, PA 19087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $799 | $0 | $799 | 6.92% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK RD ORADELL, NJ 07649 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $176 | $0 | $176 | 45.13% |
| ALLIANCE INSURANCE GROUP LLC3 Filed as: ALLIANCE INSURANCE SERVICES | 1125 SACTUARY PARKWAY ALPHARETTA, GA 30009 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $117 | $0 | $117 | 30.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA EIN 06-6033492 ADMIN | Contract Administrator Service code 13 | — | $156K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $47K |
| GENESIS ASSET PROTECTION BROKER | Insurance agents and brokers Service code 22 | 115 W COURT STREET DOYLESTOWN, PA 18901 | $35K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $16K |
| YOUNG, OAKES, BROWN & CO., P.C. EIN 25-1589048 AUDITOR | Accounting (including auditing) Service code 10 | — | $45 |
| ALLIANT INSURANCE SERVICES HOUSTON EIN 22-3723955 BROKER | Insurance agents and brokers Service code 22 | — | $0 |
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 | 401 | 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) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 353 | $105K |
| Dental | AETNA LIFE INSURANCE CO. | 353 | $105K |
| Life insurance(4 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 401 | $67K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 278 | $77K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 25 | $33K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 249 | $792K |
| Other(3 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 401 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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.