| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $59K | $21K | $80K | 18.54% |
| USI INSURANCE SERVICES LLC3 | 15350 25TH AVENUE NORTH PLYMOUTH, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $486 | $12K | 12.90% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $3K | $7K | 7.72% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $976 | $4K | 4.18% |
| KINDA JACKSON3 | 1811 BROOKSIE THOMPSON ROAD DECATURVILLE, TN 38329 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $24 | $3K | 2.90% |
| SHEILA JOHNSON3 | 276 GREENHILL DRIVE JACKSON, TN 38305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.99% |
| LINDA R MARCUM3 Filed as: LINDA R. MARCUM AND OTHER AGENTS | 1147 NORTH BROAD STREET LEXINGTON, TN 38305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $117 | $2K | 1.92% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN LUCAS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $850 | $526 | $1K | 1.42% |
| ASHLEY MARIA BARTHELEMY3 Filed as: ASHLEY BARTHELEMY | 4011 BRADDOCK AVENUE NE BUFFALO, MN 55313 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $983 | $217 | $1K | 1.24% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH LANGEVIN | 698 W LARPENTEUR AVENUE ST. PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $897 | $303 | $1K | 1.24% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $481 | $229 | $710 | 0.73% |
| JEFFREY MICHAEL OURADNIK3 Filed as: JEFFREY OURADNIK | 4203 PARKWAY DRIVE NISSWA, MN 56468 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $669 | $24 | $693 | 0.72% |
| MICHAEL A DUARTE3 Filed as: MICHAEL DUARTE | 515 DULL STREET DICKSON, TN 37055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $552 | $18 | $570 | 0.59% |
| MELISSA WOKASCH3 | 12549 STILKE LAKE ROAD FRAZEE, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $347 | — | $347 | 0.36% |
| CARRIE S FLATEN3 Filed as: CARRIE FLATEN | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $217 | $59 | $276 | 0.28% |
| MICHELLE J HALLER3 Filed as: MICHELLE HALLER | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $50 | $102 | 0.11% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE, INC. | 3357 POLK STREET NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $82 | $13 | $95 | 0.10% |
| CAROLYN GROVER3 | 206 FOX CHAPEL DRIVE IRMO, SC 29063 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $2 | $36 | 0.04% |
| TYLER JENDRO3 | 1401 5TH AVENUE SE APT 102 LITTLE FALLS, MN 56345 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.03% |
| SABRINA S RAMOS3 Filed as: SABRINA RAMOS | 13750 W. COLONIAL DRIVE WINTER GARDEN, FL 34787 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $5 | $27 | 0.03% |
| WENDY BROWNING3 | 7127 AVIGNON DRIVE ROUND ROCK, TX 78681 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $3 | $22 | 0.02% |
| CAROL BARNES3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $2 | $16 | 0.02% |
| DESIREE WENDELL3 | 40771 FENIAN WAY NORTH BRANCH, MN 55056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| JUSTIN CRAIG LAWHORN3 Filed as: JUSTIN LAWHORN | 3000 JOE DIMAGGIO BLVD ROUND ROCK, TX 78665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 0.01% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, INC. | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| SHEALY BENEFITS SERVICES INC3 Filed as: SHEALY BENEFITS SERVICES, INC. | 215 HOGAN WAY LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| BROCKSTAR LLC3 Filed as: BROCKSTAR, LLC | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| CRAIG WAYNE SOTTILE3 | 408 CEDAR PINES DRIVE GREENVILLE, SC 29615 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| WILLIAM RENNARD3 | 3001 ALOMA AVENUE WINTER PARK, FL 32792 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| NORWOOD BENEFIT SERVICES INC3 Filed as: NORWOOD BENEFIT SERVICES, INC. | 6478 LONG BREEZE ROAD ORLANDO, FL 32810 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM, INC. | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| SA GENERAL AGENCY INC3 Filed as: SA GENERAL AGENCY, INC. | 9385 MILLER LANE GARDEN RIDGE, TX 78266 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $9K | — | $9K | 19.45% |
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 | 510 | 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) | 510 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 778 | $45K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 511 | $432K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 511 | $432K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 511 | $432K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 511 | $529K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 778 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.