| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY PLACE EAST GREENBUSH, NY 12061 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $29K | $0 | $29K | 5.19% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 39840 NETWORK PLACE CHICAGO, IL 60673 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $1K | $1K | 0.25% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $20K | $0 | $20K | 10.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27K | $0 | $27K | 18.77% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 2300 REXWOOD DRIVE SUITE 200 RALEIGH, NC 27607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.70% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES JAY R. HILL, JR. | 7021 MARSEILLES COURT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $680 | $0 | $680 | 0.47% |
| JAMES R HILL JR3 Filed as: JAMES R. HILL, JR. | 7021 MARSEILLES COURT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $155 | $0 | $155 | 0.11% |
| ERIC MILLER3 | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $76 | $0 | $76 | 0.05% |
| MICHELLE REMBERTA LOCICERO3 Filed as: MICHELLE R. LOCICERO | 4447 ASHTON MEADOWS WAY WESLEY CHAPEL, FL 33543 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | $0 | $47 | 0.03% |
| FRANKLIN TRAVIS BLACK3 | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | $0 | $28 | 0.02% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M. MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.01% |
| ELIZABETH CUSHING3 | 9 WATER GARDEN WAY DURHAM, NC 27713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.01% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $8K | $0 | $8K | 7.85% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 20.00% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $211 | $0 | $211 | 11.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CLAIMS PROCESSOR | Claims processing Service code 12 | 100 PARSONS POND DRIVE FRANKLIN LAKES, NJ 07417 | $2.6M |
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 6095 MARSHALEE DRIVE ELKRIDGE, MD 21075 | $916K |
| AON CONSULTING - AHRC BROKER | Other commissions Service code 55 | P.O. BOX 905464 CHARLOTTE, NC 28290 | $0 |
| AON CONSULTING INC. - FAIRFAX EIN 22-2232264 BROKER | Other commissions Service code 55 | 806 TYVOLA ROAD SUITE 800 CHARLOTTE, NC 28217 | $0 |
| ROSE & KIERNAN INC. EIN 14-1559111 BROKER | Other commissions Service code 55 | 99 TROY ROAD EAST GREENBUSH, NY 12061 | $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 | 1,431 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIVERSITY HEALTH ALLIANCE | 11 | $103K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 1,038 | $775K |
| Vision(3 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,713 | $212K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,413 | $559K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 24 | $24K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,975 | $245K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 11 | $103K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,066 | $431K |
| Other(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,137 | $736K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,137 | — |
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.