| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 425 N MARTINGALE RD SUITE 1100 SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 0.34% |
| HUMMEL GROUP INC3 | PO BOX 3 ORRVILLE, OH 44667 | AMERICAN UNITED LIFE INSURANCE COMPANY | $17K | $2K | $19K | 7.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR SUITE 2000 CHICAGO, IL 60606 | AMERICAN UNITED LIFE INSURANCE COMPANY | $8K | — | $8K | 3.16% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $153 | $5K | 4.18% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M IGNASIAK | 8427 MUIRLAND DRIVE BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $191 | $5K | 4.14% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $440 | $3K | 2.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR CHICAGO, IL 60606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.32% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $684 | — | $684 | 0.57% |
| LINDA L MAMICK3 | 1127 FIRESIDE TRAIL BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $613 | — | $613 | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $605 | — | $605 | 0.50% |
| DIANA GILLESPIE3 | 3706 VALLEY FORGE DR STOW, OH 44224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $565 | — | $565 | 0.47% |
| HUMMEL GROUP INC3 | P.O BOX 3 ORRVILLE, OH 44667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $466 | — | $466 | 0.39% |
| STEVEN M MAMICK3 | 1127 FIRESIDE TRAIL BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $274 | — | $274 | 0.23% |
| DAVID L SMELCER3 | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $136 | — | $136 | 0.11% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE RD CLEVELAND, OH 44131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.04% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH A. WILLHITE | 3619 1/2 PONCIANA AVENUE AKRON, OH 44319 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $1K | $7K | 9.42% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M IGNASIAK | 8427 MUIRLAND DR CLEVELAND, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $288 | $6K | 7.84% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $231 | $6K | 7.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR CHICAGO, IL 60606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 6.56% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 4.03% |
| RITA A FOUBERT3 | 4888 110TH ST MONTEZUMA, IA 50171 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $630 | $3K | 3.72% |
| JOSEPH P CALARCO3 Filed as: JOSEPH MICHAEL EVANS | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $766 | $1K | $2K | 3.02% |
| BRYON A BROWDER3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $85 | $1K | 1.97% |
| RICHARD J GINTHER3 | 4220 LINCOLN AVENUE DES MOINES, IA 50310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $64 | $1K | 1.82% |
| AON CONSULTING INC3 Filed as: TRACI J HEWITT | 2809 BARROWS AVE TRACY, IA 50256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $582 | — | $582 | 0.79% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $709 | $4K | 10.06% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M IGNASIAK | 8427 MUIRLAND DR CLEVELAND, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $193 | $4K | 9.24% |
| KATHLEEN BYRNE3 | 742 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $155 | $4K | 9.14% |
| NIKGREJESKEN INC3 | 120 SHELBY RD SHERWOOD, AR 72120 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $210 | $3K | 6.41% |
| JC HAVENS INC3 | 7 JACKIE LANE CONWAY, AR 72032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $812 | $1 | $813 | 1.99% |
| GINGER MULLINS & COMPANY INC3 | 1701 CENTERVIEW DRIVE LITTLE ROCK, AR 72211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $458 | $79 | $537 | 1.32% |
| JULIE R ROLTSCH3 | 31 NEAL COVE BRYANT, AR 72022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $307 | — | $307 | 0.75% |
| ROBERT W ALLEN3 | 39 SUNCREST DR CABOT, AR 72023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $4 | $67 | 0.16% |
| VICTORIA L FLYNN3 | 7009 FAIRVIEW RD CORRYTON, TN 37721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $187 | $2K | 6.13% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H. HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $169 | $1K | 4.01% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M. IGNASIAK | 8427 MUIRLAND DR CLEVELAND, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $45 | $1K | 3.82% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $36 | $1K | 3.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR CHICAGO, IL 60606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $433 | — | $433 | 1.32% |
| MICHAEL A DUARTE3 | 515 DULL STREET DICKSON, TN 37055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $253 | $29 | $282 | 0.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $199 | — | $199 | 0.60% |
| SUSAN FONTANA FLYNN3 Filed as: SUSAN FONTANTA FLYNN | 8814 EAGLE POINT DRIVE NASHVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $11 | $101 | 0.31% |
| LINDA B ALLEN3 Filed as: LINDA B. ALLEN | 110 MOUNTAIN VIEW DRIVE ROCKY MOUNT, VA 24151 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 285 COZZINS STREET COLUMBUS, OH 43215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.10% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $4 | $14 | 0.04% |
| RAYMOND B LINGLE3 Filed as: RAYMOND B. LINGLE | 192 SUMMERFIELD COURT ROANOKE, VA 24019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| CAROL LEE HOLDEN3 | 5312 RADIANT LANE AMARILLO, TX 79109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $207 | $7 | $214 | 1.12% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H. HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $189 | $10 | $199 | 1.04% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | $2 | $122 | 0.64% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M. IGNASIAK | 8427 MUIRLAND DR CLEVELAND, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | $1 | $94 | 0.49% |
| DIANA GILLESPIE3 | 3706 VALLEY FORGE DR STOW, OH 44224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.46% |
| MELODIE F FONTENOT3 Filed as: MELODIE F. FONTENOT | 5224 75TH STREET LUBBOCK, TX 79424 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.43% |
| HELEN RODRIGUEZ-BURTON3 | PO BOX 10021 AMARILLO, TX 79116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $20 | $43 | 0.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR CHICAGO, IL 60606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.21% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE RD CLEVELAND, OH 44131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 285 COZZINS STREET COLUMBUS, OH 43215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $1 | $22 | 0.11% |
| LES MILLER3 | 2249 INDUSTRIAL BLVD ABILENE, TX 79602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Other fees; Claims processing; Float revenue Service code 12 | — | $1.6M |
| HUB INTERNATIONAL NORTHEAST LIMITED SERVICE PROVIDER | Insurance agents and brokers; Non-monetary compensation; Other commissions Service code 22 | 1393 VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NY 11788 | $4K |
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 | 2,887 | 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) | 2,887 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,887 | $643K |
| Short-term disability(7 contracts, 3 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 637 | $532K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,887 | $397K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,887 | $397K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,887 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.