| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLOIS, IN 45208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $234 | $234 | 0.04% |
| MICHAEL A BOOK3 | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $18K | $53K | $71K | 12.60% |
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT PYKOSZ | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $33K | $988 | $34K | 6.09% |
| GREGORY KARL LARGE3 | 281 TRESSER BOULEVARD SUITE 1004 STAMFORD, CT 069013238 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $17K | $1K | $18K | 3.29% |
| JOHN J MILLER3 Filed as: JOHN LEPORE | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $833 | $1K | $2K | 0.36% |
| RICHARD PIERCE VANBENSCHOTEN3 | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $2K | — | $2K | 0.35% |
| JARAD PLUMMER3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 606063611 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $2 | $1K | 0.26% |
| JOSHUA T LIEBERMAN3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 606063611 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $352 | $1K | 0.24% |
| ALAN RICHARD3 | 2 STAMFORD PLAZA SUITE 1004 281 TRESSER BOULEVARD STAMFORD, CT 069013263 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $735 | $63 | $798 | 0.14% |
| JENNIFER PAIGE MANN3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $719 | — | $719 | 0.13% |
| ANDREW L MOORE3 | 3620 SOLAMERE DRIVE PARK CITY, UT 840608840 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | $632 | $632 | 0.11% |
| MICHAEL N PRIEDE3 | 317 GRACE LANE #250 AUSTIN, TX 78746 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $540 | — | $540 | 0.10% |
| HUCK GREEN3 | 444 S FLOWER STREET SUITE 4200 LOS ANGELES, CA 90071 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $327 | $14 | $341 | 0.06% |
| CALVIN E CHUNG3 | 973 WILLOW ROAD WINNETKA, IL 600933634 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $286 | — | $286 | 0.05% |
| PETE BOUROS3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $256 | — | $256 | 0.05% |
| MICHAEL A BOOK3 Filed as: MICHAEL RITZ | 90 PARK AVENUE FLOOR 18 NEW YORK, NY 100161322 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $216 | — | $216 | 0.04% |
| PATRICK R JARVIS3 | 2511 N GRADY AVENUE UNIT 87 TAMPA, FL 336072692 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $125 | — | $125 | 0.02% |
| RICARDO M ALFONSO3 | 2100 PONCE DE LEON BLVD SUITE 600 CORAL GABLES, FL 331345215 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $94 | — | $94 | 0.02% |
| PATRICK R JARVIS3 | 2511 N GRADY AVENUE UNIT 87 TAMPA, FL 336072692 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $31 | — | $31 | 0.01% |
| JENNIFER PAIGE MANN3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $26 | — | $26 | 0.00% |
| DANIEL OH3 | 444 S FLOWER STREET SUITE 4200 LOS ANGELES, CA 90071 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HIGHWAY BUILDING 2 SUITE 125 AUSTIN, TX 78746 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 0.43% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 977 | $523K |
| Vision | VISION SERVICE PLAN | 758 | $105K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,049 | $579K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,049 | $579K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,049 | $1.1M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,049 | $579K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,049 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.