| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAN CAFOLLA AND ASSOCIATES, INC.3 | 6503 STONE RIVER ROAD, SUITE 308 BRADENTON, FL 34203 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 5.07% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE TOLEDO, OH 43604 | UNION SECURITY INSURANCE COMPANY | $15K | — | $15K | 11.29% |
| MJ INSURANCE3 Filed as: VICTOR LYSCZEK AND VARIOUS AGENTS | 1528 CONCORD ROAD WYOMISSING, PA 19610 | AFLAC | $1K | — | $1K | 4.18% |
| WILLIAM BORNEMAN3 Filed as: WILLIAM C. BORNEMAN | 1427 BROOKE ROAD POTTSTOWN, PA 19464 | AFLAC | $539 | — | $539 | 2.15% |
| YVONNE BREWER3 Filed as: YVONNE T. BREWER | 2474 SWAMP PIKE GILBERTSVILLE, PA 19525 | AFLAC | $413 | — | $413 | 1.65% |
| DANIEL MARCIN INSURANCE INC3 Filed as: DANIEL MARCIN INSURANCE, INC. | 760 ALLEGHENY RIVER BOULEVARD SUITE 200 VERONA, PA 15147 | AFLAC | $402 | — | $402 | 1.61% |
| JAMES ELDER BROOKS3 | 1253 WEST LEESPORT ROAD LEESPORT, PA 19533 | AFLAC | $309 | — | $309 | 1.23% |
| GEORGE A BITTEL3 Filed as: GEORGE A. BITTEL | 129 MARION DRIVE MCMURRAY, PA 15317 | AFLAC | $155 | — | $155 | 0.62% |
| EVELYN J WASHCHUK3 Filed as: EVELYN J. WASHCHUK | 28 1ST STREET MOUNT CLEMENS, MI 48043 | AFLAC | $64 | — | $64 | 0.26% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE-KEUNING INSURANCE GROUP | 4808 BROADMOOR SE GRAND RAPIDS, MI 49512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $293 | — | $293 | 3.13% |
| JEREMY D SAMPSEL3 Filed as: JEREMY D. SAMPSEL | 3030 9TH STREET, SUITE 2K KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $151 | — | $151 | 1.61% |
| TAMERA YOUNGS3 Filed as: TAMERA J. YOUNGS | 12045 JENKS STREET NE BELDING, MI 48809 | CONTINENTAL AMERICAN INSURANCE COMPANY | $94 | — | $94 | 1.00% |
| MJ INSURANCE3 Filed as: EDWARD O. WALTER AND VARIOUS AGENTS | 505 CHERRY STREET SE, APARTMENT 309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $75 | — | $75 | 0.80% |
| JIM M BULLOCK3 Filed as: JIM M. BULLOCK | 3715 POWDERHORN DRIVE OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $74 | — | $74 | 0.79% |
| JEFFERY C. WERNER3 | 18096 TRUDY DRIVE SPRING LAKE, MI 49456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $73 | — | $73 | 0.78% |
| AG AND ASSOCIATES3 | 2150 ASSOCIATION DRIVE, SUITE 150 OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $55 | — | $55 | 0.59% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE TOLEDO, OH 43604 | UNITED DENTAL CARE OF MICHIGAN, INC. | $376 | — | $376 | 20.15% |
| RYAN GOLDBERG3 | 103 CHURCH STREET, SUITE 3 PHILADELPHIA, PA 19106 | AFLAC | $96 | — | $96 | 5.98% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY R. ORGERA, INC. | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $52 | — | $52 | 3.24% |
| TREVOR FENNELL3 | 11835 QUEENS BOULEVARD, SUITE 1403 FOREST HILLS, NY 11375 | AFLAC | $24 | — | $24 | 1.50% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORPORATION | 401 FRANKLIN AVENUE, SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $14 | — | $14 | 0.87% |
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 | 507 | 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) | 507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 211 | $131K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 507 | $262K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 507 | $132K |
| Other(4 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 211 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.