| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 ELM ST STE 210 CONSHOHOCKEN, PA 19428 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 17.86% |
| ACRIALPS LLC3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $461 | $2K | 45.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA | 125 E ELM STREET STE 210 CONSHOHOCKEN, PA 19428 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 29.15% |
| GEORGE MICHAEL SORRENTINO3 | 3055 RED SPRINGS DR LAS VEGAS, NV 89135 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $374 | $491 | 11.34% |
| CHRISTINA STAHL3 | 9621 CANYON MESA DR LAS VEGAS, NV 89144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $373 | $490 | 11.32% |
| ALEXANDRA DIANE SORRENTINO3 | 3055 RED SPRINGS DR LAS VEGAS, NV 89135 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $223 | $62 | $285 | 6.58% |
| BRIGATA LLC3 | 104 CAPETOWN CT UNIT 104 WEAVERVILLE, NC 28787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $196 | $74 | $270 | 6.24% |
| ASSUREDPARTNERS3 Filed as: JENNIFER RENEE BLAIR | 3949 CARLA ANN RD NORTH LAS VEGAS, NV 89081 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $197 | $53 | $250 | 5.77% |
| ROGER STUART KENCHEL3 | 2588 EL CAMINO REAL STE F188 CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $96 | $28 | $124 | 2.86% |
| CHELSEA L WARE LLC3 Filed as: CHELSEA L WARE INC | 11425 PERUGINO DR LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $0 | $117 | 2.70% |
| SHAWNEENA MERCADO OVERLY3 | 3958 PARKERS FRY FORT MILL, SC 29715 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | $10 | $78 | 1.80% |
| ERIC BROGAN3 Filed as: ERIC L MILLER | 8720 ELBE TRL FORT WORTH, TX 76118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $3 | $61 | 1.41% |
| DAWN RENEE MORGAN3 | 6413 DUNMOOR DR PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $4 | $43 | 0.99% |
| RYAN WARE3 | 11632 REGAL ROCK PL LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.32% |
| JGBENEFITS CONSULTANTS3 | 12300 FORD RD STE 450 FARMERS BRANCH, TX 75234 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.07% |
| BARBARA ANN BASTON3 | 5401 MANSEL LN FT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.05% |
| THE CAPITAL GROUP LLC3 Filed as: CAPITAL FINANCIAL STRATEGIES, INC. | 7008 SALEM AVENUE SUITE 106 LUBBOCK, TX 79424 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $132 | $10 | $142 | 9.91% |
| STRATEGIC NON-MEDICAL SOLUTION3 | PO BOX 746600 ATLANTA, MA 303746600 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $57 | $57 | 3.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN (PA) EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $8K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $8K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
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 | 36 | 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) | 36 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 0 | $0 |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 0 | $0 |
| Life insurance(2 contracts, 2 carriers) | BOSTON MUTUAL LIFE INSURANCE COMPANY | 36 | $7K |
| Short-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 27 | $112K |
| Other(3 contracts, 3 carriers) | BOSTON MUTUAL LIFE INSURANCE COMPANY | 36 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 36 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.