| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $35K | $0 | $35K | 6.10% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $0 | $0 | 0.00% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNANC INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $20K | $8K | $28K | 14.03% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20K | $0 | $20K | 13.39% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 2300 REXWOOD DRIVE SUITE 200 RALEIGH, NC 27607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.64% |
| MICHELLE REMBERTA LOCICERO3 Filed as: MICHELLE R LOCICERO | 7526 CATTLE DRIVE PLANT CITY, FL 33565 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.47% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES JAY R HILL, JR. | 7021 MARSEILLES COURT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $668 | $0 | $668 | 0.44% |
| JAMES R HILL JR3 Filed as: JAMES R HILL, JR. | 7021 MARSEILLES COURT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $135 | $0 | $135 | 0.09% |
| ERIC MILLER3 | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $75 | $0 | $75 | 0.05% |
| FRANKLIN TRAVIS BLACK3 | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | $0 | $26 | 0.02% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | $0 | $13 | 0.01% |
| ELIZABETH CUSHING3 | 9 WATER GARDEN WAY DURHAM, NC 27713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | $0 | $13 | 0.01% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.45% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $334 | $4K | 22.04% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $173 | $29 | $202 | 12.85% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $93 | $0 | $93 | 6.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CLAIMS PROCESS0R | Claims processing Service code 12 | 100 PARSONS POND DRIVE FRANKLIN LAKES, NJ 07417 | $2.7M |
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 6095 MARSHALEE DRIVE ELKRIDGE, MD 21075 | $1.2M |
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 CLAIMS PROCESSOR | Claims processing Service code 12 | 7 SKYLINE DRIVE, #275 HAWTHORNE, NY 10532 | $26K |
| AON CONSULTING - AHRC BROKER | Other commissions Service code 55 | P.O. BOX 905464 CHARLOTTE, NC 28290 | $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 | 1,350 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIVERSITY HEALTH ALLIANCE | 11 | $130K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 976 | $738K |
| Vision(3 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 1,634 | $226K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 21 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 548 | $201K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 11 | $130K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,015 | $466K |
| Other(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,154 | $744K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,154 | — |
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.