| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GILBERT INSURANCE AGENCY INC3 | P.O. BOX 688 SHARON, PA 16146 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | — | $14K | 5.09% |
| CHRISTOPHER L MOLDAS3 | 353 EXCEL LANE MOGADORE, OH 44260 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $1K | $12K | 4.55% |
| DIANA GILLESPIE3 | 353 EXCEL LANE MOGADORE, OH 44260 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 2.00% |
| CAROL JANE RILEY3 | 13911 LISBON ROAD SALEM, OH 44460 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $80 | $3K | 1.06% |
| MICHAEL R ACKERMAN3 | 435 DEVON PARK DR WAYNE, PA 19087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $141 | $2K | 0.77% |
| DANEEN MARIE PURPURA3 | 4228 ROYALWOOD ROAD N. ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $55 | $1K | 0.52% |
| ANTHONY VESTAL3 | 3856 ISLAND WAY SOUTH ST PETERSBURG, FL 33705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $817 | $128 | $945 | 0.35% |
| KAREN L VARGO3 | 949 SHOREWOOD DR FREMONT, OH 43420 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $559 | — | $559 | 0.21% |
| GRUND BENEFIT ADVISORS LLC3 | 14669 MEREDITH AVE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $3 | $137 | 0.05% |
| HENRY J SAMAAN3 Filed as: HENRY JACOB SAMAAN | 19W152 21ST PLACE LOMBARD, IL 60148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $45 | $116 | 0.04% |
| GERALD A GREENEN3 | 1212 S. NAPER BLVD NAPERVILLE, IL 60540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.02% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $2 | $7 | 0.00% |
| INFINUIUM ENTERPRISES LLC3 | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| GSD KATIE K MILLER INC3 | 30 SOUTHFORK RD DADEVILLE, AL 36853 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| GILBERT INSURANCE AGENCY INC3 | 30 E STATE STREET SHARON, PA 16146 | UNITED CONCORDIA INSURANCE COMPANY | $9K | — | $9K | 7.98% |
| GILBERT INSURANCE AGENCY INC3 | P.O. BOX 688 SHARON, PA 16146 | VISION BENEFITS OF AMERICA | $2K | — | $2K | 5.00% |
| GILBERTS INSURANCE AGENCY INC3 Filed as: GILBERTS INSURANCE AGENCY | 30 E STATE STREET SHARON, PA 16146 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.50% |
| GILBERT INSURANCE AGENCY INC3 | 30 E STATE STREET SHARON, PA 16146 | THE PAUL REVERE LIFE INSURANCE COMPANY | $108 | — | $108 | 5.37% |
| DIANA GILLESPIE3 | 353 EXCEL LANE MOGADORE, OH 44260 | THE PAUL REVERE LIFE INSURANCE COMPANY | $104 | — | $104 | 5.17% |
| CAROL JANE RILEY3 | 13911 LISBON ROAD SALEM, OH 44460 | THE PAUL REVERE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.55% |
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 | 247 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 188 | $111K |
| Vision | VISION BENEFITS OF AMERICA | 149 | $36K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 312 | $284K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 312 | $282K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 190 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.