| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | QUARTZ HEALTH BENEFIT PLANS CORP. | $14K | — | $14K | 2.94% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | AMERITAS LIFE INSURANCE CORP. | $61K | $1K | $62K | 15.25% |
| BESVINICK, MITCHELL, HENRY3 | 1280 BRIGHTON WAY NEWTOWN SQ, PA 19073 | AMERITAS LIFE INSURANCE CORP. | $20K | — | $20K | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | $9K | $35K | 15.78% |
| BENEFITELECT INC.5 | 855 SW YATES DR., STE. 202 BEND, OR 97702 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 3.00% |
| MITCHEL H BESVINICK3 | 1280 BRIGHTON WAY NEWTON SQUARE, PA 19073 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 2.19% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY JR. | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $4K | $8K | 22.62% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 19.85% |
| MITCHELL H BESVINICK3 Filed as: MITCHELL H. BESVINICK | 1280 BRIGHTON WAY NEWTOWN SQUARE, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.47% |
| CHRISTINE L COURTNEY3 Filed as: CHRISTINE L. COURTNEY | 333 WEEKSRIDGE LANE MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $783 | $338 | $1K | 3.32% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM INC. | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $534 | $575 | $1K | 3.29% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $258 | $111 | $369 | 1.09% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY JR. | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 16.49% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 10.48% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM INC. | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $344 | $320 | $664 | 2.08% |
| CHRISTINE L COURTNEY3 | 333 WEEKSRIDGE LANE MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $426 | $153 | $579 | 1.82% |
| MITCHELL H BESVINICK3 Filed as: MITCHELL H. BESVINICK | 1280 BRIGHTON WAY NEWTOWN SQUARE, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $576 | — | $576 | 1.81% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | $51 | $193 | 0.61% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY JR. | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 13.79% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 9.49% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM INC. | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $295 | $251 | $546 | 1.74% |
| CHRISTINE L COURTNEY3 | 333 WEEKSRIDGE LANE MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $394 | $129 | $523 | 1.66% |
| MITCHELL H BESVINICK3 | 1280 BRIGHTON WAY NEWTOWN SQUARE, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $510 | — | $510 | 1.62% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | $43 | $174 | 0.55% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY JR. | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $3K | 28.29% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 21.77% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM INC. | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $251 | $283 | $534 | 4.81% |
| MITCHELL H BESVINICK3 Filed as: MITCHELL H. BESVINICK | 1280 BRIGHTON WAY NEWTOWN SQUARE, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $432 | — | $432 | 3.89% |
| CHRISTINE L COURTNEY3 | 333 WEEKSRIDGE LANE MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275 | $124 | $399 | 3.59% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD. NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | $41 | $132 | 1.19% |
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 | 792 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORP. | 72 | $483K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 792 | $407K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 792 | $407K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 863 | $224K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 863 | $224K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 863 | $224K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORP. | 72 | $483K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 863 | $332K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 863 | — |
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.