| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | — | EQUITABLE | — | $7K | $7K | 5.00% |
| ACRISURE LLC3 | — | EQUITABLE | $5K | — | $5K | 3.51% |
| ACRISURE LLC3 | 255 BANK STREET WATERBURY, CT 06702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33K | $16K | $48K | 38.97% |
| ACRIALPS LLC3 | C/O ACRIALPS LLC GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29K | $9K | $38K | 30.92% |
| ASSUREDPARTNERS3 Filed as: JENNIFER RENEE BLAIR | 3949 CARLA ANN RD NORTH LAS VEGAS, NV 89081 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $5K | 3.78% |
| CHRISTINE MARIE MCKINNIS3 | 429 WATERWHEEL FALLS DR HENDERSON, NV 89015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $597 | $4K | 2.84% |
| CHELESA L WARE LLC3 | 233 W 21ST ST NEW YORK, NY 10011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.84% |
| LISA MARIE SAWOYA3 | 256 SOUTHWEST 137TH STREET BURIEN, WA 98166 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.80% |
| JENNIFER JEAN MOYA3 | 24548 VIA LAS LADERAS MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $214 | $1K | 1.17% |
| CHERYL LYNN GAONA3 | 11912 KILLIAN ST EL MONTE, CA 91732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $160 | $1K | 0.96% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DRIVE MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $862 | $241 | $1K | 0.89% |
| EDWARD D SOMMER3 Filed as: EDWARD GUY JR | 716 RED FERN ROAD TALLAHASSEE, FL 32308 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $677 | $149 | $826 | 0.67% |
| SHAWNEENA MERCADO OVERLY3 | 3958 PARKER FERRY FORT MILL, SC 29715 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $568 | $91 | $659 | 0.53% |
| ROGER STUART KENCHEL3 | 2588 EL CAMINO REAL CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $464 | $177 | $641 | 0.52% |
| VIP INSURANCE INC3 | 18 STONEMARK DR HENDERSON, NV 89052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $464 | $131 | $595 | 0.48% |
| ERIC BROGAN3 Filed as: ERIC L MILLER | 8720 ELBE TRL FORT WORTH, TX 76118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $526 | $30 | $556 | 0.45% |
| MELLONEASE KIRKSEY3 | 1664 CEDAR SPRINGS CT CLARKSVILLE, TN 37042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $487 | $58 | $545 | 0.44% |
| DOMINICK R SIRACUSA3 Filed as: DOMINICK MICHAEL SORRENTINO | 104 STOCKTON KINGS COURT LAS VEGAS, NV 89148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $439 | $53 | $492 | 0.40% |
| KARLA ALEXANDER3 | 3524 OBERON LN N LAS VEGAS, NV 89032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $371 | $51 | $422 | 0.34% |
| ANTONIA DAVILA3 Filed as: ANTONIA MARIA HOLDEN | 8932 CREEKFORD ST LAKESIDE, CA 92040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $283 | $90 | $373 | 0.30% |
| MEGAN WILSON3 | 7534 SLIPPER ORCHID STREET LAS VEGAS, NV 89148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $238 | $56 | $294 | 0.24% |
| RYAN WARE3 | 9621 CANYON MESA DR LAS VEGAS, NV 89144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $273 | — | $273 | 0.22% |
| LOYDA VALDEZ3 | 1894 EAST 40 NORTH ST GEORGE, UT 84790 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $226 | $28 | $254 | 0.21% |
| DONNA MARIE MCCANN3 | 8785 KIOWA TRAIL KISSIMMEE, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $243 | — | $243 | 0.20% |
| BRIGATA LLC3 | 104 CAPETOWN CT UNIT 104 WEAVERVILLE, NC 28787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $166 | $37 | $203 | 0.16% |
| ALEXANDRA DIANE SORRENTINO3 | 3055 RED SPRINGS DR LAS VEGAS, NV 89144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | $46 | $193 | 0.16% |
| BRIAN WHITE3 Filed as: BRIAN E KROK | 104 CAPETOWN CT UNIT 104 WEAVERVILLE, NC 28787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $138 | $50 | $188 | 0.15% |
| BOELZNER AND ASSOC INS SVCS3 Filed as: BOELZNER AND ASSOCIATES INSURANCE | PO BOX 269 PALM DESERT, CA 92261 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | — | $97 | 0.08% |
| DEBORAH RUSH KIMMONS3 | 37291 BOSLEY ST INDIO, CA 92203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.06% |
| TERRELL & COMPANY INC3 Filed as: TERRELL AGENCY INC | 1644 STUBBS VINSON RD MONROE, LA 71203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $13 | $71 | 0.06% |
| KIM REED SMITH3 Filed as: KIM R TERRELL | 1644 STUBBS VINSON RD MONROE, LA 71203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.06% |
| JACK F KIMMONS3 | 37291 BOSLEY ST INDIO, CA 92203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.05% |
| KATHLEEN SPILLMAN-OREL3 | 1499 OLD MOUNTAIN RD SAN JACINTO, CA 92583 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.04% |
| JOEY MIGUES3 Filed as: JOEY GRUBBS BENEFITS LLC | 525 TAYLOR RD MONTICELLO, FL 32344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $7 | $36 | 0.03% |
| CINDY V SHIELDS3 Filed as: CINDY PAMELA REYES-MEDINA | 2617 RIALTO RD LAS VEGAS, NV 89108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $3 | $31 | 0.03% |
| THE CAPITAL GROUP LLC3 Filed as: CAPITAL FINANCIAL STRATEGIES INC | 4402 93RD DR LUBBOCK, TX 79424 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $7 | $30 | 0.02% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $10 | $30 | 0.02% |
| DAVID J MCCLELLAN3 Filed as: DAVID B MERKHOFER | 2704 SETTER PL TALLAHASSEE, FL 32303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.02% |
| LORI LAINE3 Filed as: LORI LANE | 34676 CONADRIA AVE YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.02% |
| ZACHAREE KEITH SIAHPUSH3 | 4412 RENTON AVE S SEATTLE, WA 98108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $3 | $23 | 0.02% |
| BRUCE W BUSSER3 | 22461 SAN JOAQUIN DRIVE WEST CANYON LAKE, CA 92587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 77564 COUNTRY CLUB PALM DESERT, CA 92211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| BARBARA ELLEN SMITH3 | 4040 EAST PIEDMONT DR HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| GCG FINANCIAL LLC3 Filed as: TERRANCE HUGH DICKERSON | 1916 ORANGE TREE LANE REDLANDS, CA 92374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| SUSIE A ESTRADA3 | 25742 PARK AVENUE SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| COURTNEY MCFARLAND3 | 8321 W SAHARA AVE APT 2128 LAS VEGAS, NV 89117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| G SCOTT COOKE3 Filed as: SCOTT C CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| WANDA MCGINTY3 | 29075 RED TAIL COURT HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| JOHN D EVANGELISTA3 | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| ACRISURE LLC3 | 40 CORPORATE AVE PLAINVILLE, CT 06062 | STANDARD INSURANCE COMPANY | $960 | — | $960 | 6.73% |
| ACRISURE LLC3 | 255 BANK STREET WATERBURY, CT 06702 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | — | $2K | 29.93% |
| ACRIALPS LLC3 | C/O ACRIALPS LLC GRAND RAPIDS, MI 49501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | — | $2K | 27.44% |
| ASSUREDPARTNERS3 Filed as: JENNIFER RENEE BLAIR | 3949 CARLA ANN RD NORTH LAS VEGAS, NV 89081 | THE PAUL REVERE LIFE INSURANCE COMPANY | $354 | $136 | $490 | 6.94% |
| CINDY V SHIELDS3 Filed as: CINDY PAMELA REYES-MEDINA | 2617 RIALTO RD LAS VEGAS, NV 89108 | THE PAUL REVERE LIFE INSURANCE COMPANY | $374 | $26 | $400 | 5.67% |
| SHAWNEENA MERCADO OVERLY3 | 3958 PARKER FERRY FORT MILL, SC 29715 | THE PAUL REVERE LIFE INSURANCE COMPANY | $267 | $53 | $320 | 4.53% |
| CHELESA L WARE LLC3 | 233 W 21ST ST NEW YORK, NY 10011 | THE PAUL REVERE LIFE INSURANCE COMPANY | $141 | — | $141 | 2.00% |
| CHRISTINE MARIE MCKINNIS3 | 429 WATERWHEEL FALLS DR HENDERSON, NV 89015 | THE PAUL REVERE LIFE INSURANCE COMPANY | $64 | $14 | $78 | 1.10% |
| RYAN WARE3 | 9621 CANYON MESA DR LAS VEGAS, NV 89144 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17 | — | $17 | 0.24% |
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 | 229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EQUITABLE | 181 | $139K |
| Vision | STANDARD INSURANCE COMPANY | 159 | $14K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 95 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.