| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN WESTBROOK INS SERVICES LLC3 | 4 WESTBROOK CORPORATION CTR STE 500 WESTCHESTER, IL 60154 | UNITEDHEALTH INSURANCE COMPANY | $14K | — | $14K | 4.20% |
| ADVANCED INSURANCE SERVICES INC3 Filed as: ADVANCED INSURANCE AGENCY, INC. | 24705 MOUND RD WARREN, MI 48091 | HEALTH ALLIANCE PLAN | $11K | — | $11K | 5.06% |
| NONE | — | BLUE CROSS AND BLUE SHIELD OF ALABAMA | — | — | $0 | 0.00% |
| HUNTER BENEFITS GROUP LLC3 | 10940 S PARKER RD STE 306 PARKER, CO 801347440 | HUMANA HEALTH PLAN, INC. - GOLD | $1K | — | $1K | 1.94% |
| COAST QUOTES INSURANCE AGENCY, INC3 | PO BOX 4585 MISSION VIEJO, CA 92690 | KAISER FOUNDATION HEALTH PLANS INC | $4K | — | $4K | 6.90% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, STE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS - KEYSTONE HEALTH PLAN EAST | $4K | — | $4K | 8.95% |
| HUNTER BENEFITS GROUP LLC3 | 10940 S PARKER RD STE 306 PARKER, CO 80134 | HUMANA HEALTH PLAN, INC. - SILVER | $2K | — | $2K | 5.04% |
| KUNRATH & WILLARD INSURANCE SERV. L3 | 825 NE 20TH AVE. #320 PORTLAND, OR 97232 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $920 | — | $920 | 4.35% |
| ADVANCED INSURANCE SERVICES INC3 Filed as: ADVANCED INSURANCE AGENCY, INC. | 24705 MOUND RD WARREN, MI 48091 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $688 | $2K | 11.72% |
| LUCIDO MORRIS ASSOCIATES, LLC3 | 24255 W 13 MILE ROAD SUITE 250 BINGHAM FARMS, MI 48025 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $20 | — | $20 | 0.14% |
| WILLIAM WADSWORTH3 | 1211 N. DAVIS RD EAST AURORA, NY 14052 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $379 | $2K | 12.48% |
| ALLIANCE ADVISORY GRP INC3 Filed as: ALLIANCE ADVISORY GRP INC. | 350 ESSJAY ROAD SUITE 301 WILLIAMSVILLE, NY 14221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24 | — | $24 | 0.19% |
| HUNTER BENEFITS GROUP LLC3 Filed as: THE HUNTER BENEFITS GROUP LLC | 1297 GAMBEL OAKS PL ELIZABETH, CO 80107 | DELTA DENTAL OF COLORADO | $809 | — | $809 | 9.95% |
| CENTERSTONE INSURANCE AND FINANCIAL6 Filed as: CENTERSTONE INSURANCE | 4851 LBJ FREEWAY STE 1100 DALLAS, TX 75244 | DELTA DENTAL OF COLORADO | $324 | — | $324 | 3.98% |
| NONE | — | INDEPENDENCE BLUE CROSS - KEYSTONE 65 | — | — | $0 | 0.00% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, STE 200 BERWYN, PA 19312 | UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. | $209 | — | $209 | 10.31% |
| MICHAEL LOVE3 | PO BOX 4585 MISSION VIEJO, CA 92690 | SAFEGUARD HEALTH PLANS INC | $120 | — | $120 | 9.49% |
| MARIBETH TENNISON3 | 3720 S. SUSAN ST., SUITE 200 SANTA ANA, CA 92704 | SAFEGUARD HEALTH PLANS INC | $96 | — | $96 | 7.59% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, STE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS - MED. SUP. | $153 | — | $153 | 14.34% |
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 | 95 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 95 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(11 contracts, 11 carriers) | UNITEDHEALTH INSURANCE COMPANY | 67 | $1.1M |
| Dental(6 contracts, 5 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 29 | $161K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 29 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 67 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.