| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M&T INSURANCE AGENCY INC3 Filed as: M & T INSURANCE AGENCY INC. | 285 DELAWARE AVE SUITE 400 BUFFALO, NY 14202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $600 | $600 | 0.06% |
| O'NEILL VOLUNTARY BENEFIT SERVICES3 | 5626 KIRKWOOD HIGHWAY WILLMINGTON, DE 19808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $336 | $2K | 9.22% |
| NICHOLAS CUSMANO3 | 79 PORT HERMAN ROAD CHESAPEAKE CY, MD 21915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $22 | $1K | 5.61% |
| ROTH VOLUNTARY BENEFIT SERVICES INC3 | 9 DEARBORN LANE BEAR, DE 19701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $663 | $117 | $780 | 3.86% |
| BRAD BIEL3 Filed as: BRAD LEE MUNDY | 108 BALMORE LANE WILMINGTON, DE 19808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $209 | $8 | $217 | 1.07% |
| LYONS INSURANCE AGENCY INC3 | 501 CARR ROAD SUITE 301 WILMINGTON, DE 19809 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | — | $105 | 0.52% |
| EDWARD D SOMMER3 Filed as: EDWARD P DOUGHERTY INC. | 4550 PRESTWICK DR READING, PA 19606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $5 | $69 | 0.34% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $5 | $10 | 0.05% |
| ERNESTO MCKENZIE JR3 | 8293 WB AND A RD SEVERN, MD 21144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.04% |
| O'NEILL VOLUNTARY BENEFIT SERVICES3 | 5626 KIRKWOOD HIGHWAY WILMINGTON, DE 19808 | THE PAUL REVERE LIFE INSURANCE COMPANY | $951 | $80 | $1K | 6.72% |
| NICHOLAS CUSMANO3 | 79 PORT HERMAN RD CHESAPEAKE CY, MD 21915 | THE PAUL REVERE LIFE INSURANCE COMPANY | $710 | — | $710 | 4.63% |
| LYONS INSURANCE AGENCY INC3 | 501 CARR ROAD SUITE 301 WILMINGTON, DE 19809 | THE PAUL REVERE LIFE INSURANCE COMPANY | $177 | — | $177 | 1.15% |
| EVELYN GARCIA3 | 55 BROADWAY NEW YORK, NY 10028 | THE PAUL REVERE LIFE INSURANCE COMPANY | $10 | — | $10 | 0.07% |
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 | 80 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 80 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 98 | $946K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 98 | $931K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $16K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 33 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $16K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.