| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 6.13% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 8.53% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.70% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 14.18% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $985 | — | $985 | 5.49% |
| G R S INC3 | 3278 TAHOE COURT NAPLES, FL 34119 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $1 | $95 | 2.73% |
| DANA MARIE MOWATT3 | 23701 SOUTH WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.69% |
| PENELOPE DEAN KENNY3 | 3555 SOUTH OCEAN BOULEVARD APARTMENT 215 SOUTH PALM BEACH, FL 33480 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.52% |
| OWENS EMPLOYEE BENEFITS OF FLORIDA3 | 13650 FIDDLESTICKS BOULEVARD FORT MYERS, FL 33912 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $3 | $7 | 0.20% |
| THOMAS WALLACE JR3 | 57 WYN OAK DRIVE NASHVILLE, TN 37205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.20% |
| ROSEANN REYNOLDS3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.06% |
| DAVID L FLEURY3 | 56 STRAWBERRY LANE PORTSMOUTH, RI 02871 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| VANESSA N DEAN3 | 92 LIMEWOOD AVENUE BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 309 | $18K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 314 | $110K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 312 | $41K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 314 | $53K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 422 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.