| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | UNITED OF OMAHA | $17K | $5K | $22K | 11.74% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $930 | — | $930 | 6.22% |
| GRS INC3 Filed as: GRS | 3278 TAHOE CT NAPLES, FL 34119 | COLONIAL LIFE AND ACCIDENT | $181 | $51 | $232 | 6.54% |
| PENELOPE DEAN KENNY3 | 3555 S OCEAN BLVD, APT 215 S PALM BEACH, FL 33480 | COLONIAL LIFE AND ACCIDENT | $87 | — | $87 | 2.45% |
| D M MOWATT3 | 23701 S WESTERN AVE., STE 112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT | $56 | $4 | $60 | 1.69% |
| OWENS EMPLOYEE BENEFITS OF FLORIDA3 | 13650 FIDDLESTICKS BLVD FORT MYERS, FL 33912 | COLONIAL LIFE AND ACCIDENT | $7 | $7 | $14 | 0.39% |
| ROSEANN REYNOLDS3 | 163 CEDAR ST BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT | $7 | $6 | $13 | 0.37% |
| GROUP SUPPLEMENTAL BENEFITS INC3 Filed as: GROUP SUPPLEMENTAL BENEFITS, INC. | 31805 TEMECULA PARKWAY TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT | $5 | $4 | $9 | 0.25% |
| THOMAS WALLACE JR3 Filed as: THOMAS WALLACE | PO BOX 3654 PONTE VERDA, FL 32004 | COLONIAL LIFE AND ACCIDENT | $8 | — | $8 | 0.23% |
| VANESSA N DEAN3 | 92 LIMEWOOD AVE BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT | $7 | — | $7 | 0.20% |
| DAVID L FLEURY3 | 56 STRAWBERRY LANE PORTSMOUTH, RI 02871 | COLONIAL LIFE AND ACCIDENT | $4 | $1 | $5 | 0.14% |
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 | 306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 309 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 177 | $15K |
| Life insurance | UNITED OF OMAHA | 306 | $185K |
| Short-term disability | UNITED OF OMAHA | 306 | $185K |
| Long-term disability | UNITED OF OMAHA | 306 | $185K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA | 336 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.