| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF COLORADO, INC. | 1125 17TH STREET, SUITE 1450 DENVER, CO 80202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $6K | $6K | 0.09% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $27K | $27K | 3.51% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $136 | $136 | 0.02% |
| MORRIS & BOYLE3 | 1850 MOUNT DIABLO BOULEVARD SUITE 430 WALNUT CREEK, CA 94596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19K | $12K | $31K | 9.09% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 375 NORTHRIDGE ROAD, SUITE 515 ATLANTA, GA 30350 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $4K | $20K | 5.88% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $8K | $8K | 2.22% |
| MADISON GROUP, INC.3 | 5299 DTC BOULEVARD, SUITE 1100 GREENWOOD VILLAGE, CO 80111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $189 | $6K | 1.70% |
| KENNETH C YARBROUGH3 Filed as: KENNETH C. YARBROUGH | 3224 LANIER DRIVE ATLANTA, GA 30319 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $800 | $2K | $3K | 0.74% |
| DONALD EUGENE MORRIS3 | 1850 MOUNT DIABLO BOULEVARD SUITE 430 WALNUT CREEK, CA 94596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.57% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 3700 PARK EAST DRIVE, SUITE 350 BEACHWOOD, OH 44122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $377 | $377 | 0.11% |
| MORRIS & BOYLE3 | 1850 MOUNT DIABLE BOULEVARD SUITE 430 WALNUT CREEK, CA 94596 | EXCEPTIONAL RISK ADVISORS | $11K | $0 | $11K | 12.14% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 375 NORTHRIDGE ROAD, SUITE 515 ATLANTA, GA 30350 | EXCEPTIONAL RISK ADVISORS | $11K | $0 | $11K | 12.14% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL GROUP | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | EXCEPTIONAL RISK ADVISORS | $1K | $0 | $1K | 1.46% |
| MORRIS & BOYLE3 | 1850 MOUNT DIABLO BOULEVARD SUITE 430 WALNUT CREEK, CA 94596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 10.41% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 375 NORTHRIDGE ROAD, SUITE 515 ATLANTA, OR 30350 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $438 | $3K | 4.98% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1K | $1K | 2.26% |
| MADISON GROUP, INC.3 | 5299 DTC BOULEVARD, SUITE 1100 GREENWOOD VILLAGE, CO 80111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $838 | $19 | $857 | 1.55% |
| KENNETH C YARBROUGH3 Filed as: KENNETH C. YARBROUGH | 3224 LANIER DRIVE ATLANTA, GA 30319 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $175 | $213 | 0.39% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 3659 GREEN ROAD, SUITE 322-8 BEACHWOOD, OR 44122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $37 | $37 | 0.07% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | THE PAUL REVERE LIFE INSURANCE COMPANY | $0 | $331 | $331 | 6.20% |
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 | 642 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 657 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 455 | $6.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 798 | $268K |
| Vision | VISION SERVICE PLAN | 393 | $55K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 642 | $770K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 642 | $770K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 455 | $6.5M |
| Other(6 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 642 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 798 | — |
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.