| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, LLC | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $56 | $5K | 4.52% |
| MARC A GROVE3 Filed as: MARC GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $82 | $4K | 3.62% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTUER AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $483 | $16 | $499 | 0.43% |
| TAMMY M DAHLBERG3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $369 | — | $369 | 0.32% |
| CEDORA B LEVINER3 | PO BOX 758 KANNAPOLIS, NC 28082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $196 | — | $196 | 0.17% |
| DAVID UNDERWOOD3 | PO BOX 32694 CHARLOTTE, NC 28232 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $195 | — | $195 | 0.17% |
| KAREN BOHLER3 | 12810 PRIMROSE LN EDEN PRAIRIE, MN 55344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $40 | $174 | 0.15% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 0.09% |
| PATRICIA L CARON3 | 190 TESUQUE VILLIAGE ROAD SANTA FE, NM 87506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.09% |
| TONI E STEED LLC3 | 11218 WARFIELD AVE HUNTERSVILLE, NC 28078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.08% |
| LINDA B ALLEN3 Filed as: LINDA ALLEN | 110 MOUNTAIN VIEW DR ROCKY MOUNT, VA 24151 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 0.07% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | $5 | $79 | 0.07% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | $1 | $74 | 0.06% |
| DESIREE WENDELL3 | 40771 FENIAN WAY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 0.06% |
| LYNDA TANNER3 | PO BOX 1225 SEABROOK, TX 77586 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.05% |
| SHARON LEA HART3 | PO BOX 1872 HILLTOP LAKES, TX 77871 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.04% |
| JAMES SNOW3 | 286 CASTLEGATE RD MACON, GA 31210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.03% |
| SHEILA A SHELL3 Filed as: SHEILA SHELL | 413 MOSS TRAIL GOODLETTSVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.03% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE RD FRAZEE, MN 56544 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.02% |
| CAROLINA REGIONAL INSURANCE3 | PO BOX 8808 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.02% |
| KENNETH RONALD LENT3 | 1040 KINGFISHER WAY ROCKLEDGE, FL 32955 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.02% |
| GLENN ZIMMERMAN INC3 Filed as: GLENN ZIMMERMAN INC. | 1510 HIGH ROCK RD GIBONSVILLE, NC 27249 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.02% |
| RODNEY G STORCK3 | 609 NORTH BROADWAY WICHITA, KS 67214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.02% |
| DANIEL R DEDRICK3 | 1899 CYPRESS DRIVE GRAFTON, WI 53024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.02% |
| RICHARD J GINTHER3 | 4220 LINCOLN AVE DES MONIES, IA 50310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.02% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $8 | $21 | 0.02% |
| TIMOTHY B DONNELLY3 | 5960 92ND AVE N PINNELLAS PARK, FL 33782 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE, #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| KENNETH LAWRENCE CROUCH3 | 550 CATAWABA DRIVE SALISBURY, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| BRIAN COHEN3 | 701 LEORA LN THE COLONY, TX 75056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| PAUL J GEBOLYS3 Filed as: PAUL GEBOLYS | 14 PINEASH CT THE WOODLANDS, TX 77381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| JOHN PHILIP RHODES JR3 | 136 N HERMITAGE RD BEAUFORT, SC 29902 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| JAMES CLARK3 | 500 FAIRWAY COURT NEWMAN, GA 30265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| JORDANO GROUP INC3 Filed as: JORDANO GROUP INC. | 12751 ORANGE BLVD WEST PALM BEACH, FL 33412 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| BOBBY SCALES SR AND ASSOCIATES3 Filed as: BOBBY SCALES SR. AND ASSOCIATES | 6945 LANCASTER CIR CUMMING, GA 30040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| EMMA ANN DEAN3 | 350 SOUTH BELVEDERE DRIVE HAMPSTEAD, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $1 | $13 | 0.01% |
| CHALSEE CANTRELL3 | 1007 THISTLE DRIVE MESQUITE, TX 75149 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $2 | $13 | 0.01% |
| DAVID PURVIS3 | 3840 SADDLE BEND DRIVE OLIVE BRANCH, MS 38654 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| DOROTHY RING3 | 8300 PLAZA JACKSONVILLE, FL 32217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| APRIL MECHATTO3 Filed as: APRIL MACHATTO | 5107 OBRYAN AVE GULFPORT, MS 39507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| DONALD R JAWORSKI3 | 20819 ORCHARD DRIVE LAND O LAKES, FL 34638 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| BIEBER CHRISTINA3 | 12827 WOODMILL DRIVE PALM BEACH GARDENS, FL 33418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| TROY J PALMER3 | 15534 CLOVER RDG SAN ANTONIO, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| DEIRDRE B HOEHN3 Filed as: DEIRDRE HOEHN | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| BILLY MARK ROBERSON3 | 17415 SHADY CANYON SAN ANTONIO, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| OMAR MENDOZA3 | 26326 ROCKWALL PKWY NEW BRAUNFELS, TX 78132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| ANDREW G NIKOVITS3 | 22153 NATURES COVE CT ESTERO, FL 33928 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| ROSA SHALA3 | 16112 HARBOR VISTA CIR ST. AUGUSTINE, FL 32080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| KELLY MELISSA KRISCH3 | 725 RIVER BLUFF DRIVE LYTLE, TX 78052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| DORIS M KERCHNER3 Filed as: DORIS KERCHNER | 1875 KERRY CREEK DRIVE MARIETTA, GA 30066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| DORIS M KERCHNER3 Filed as: DORIS KERCHNER | 1875 KERRY CREEK DRIVE MARIETTA, GA 30066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| DORIS M KERCHNER3 Filed as: DORIS KERCHNER | 1875 KERRY CREEK DRIVE MARIETTA, GA 30066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| JENNIFER ROSE SMITH3 | 4920 W SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| BONNIE J WENDELL3 Filed as: BONNIE WENDELL | 2555 PALM AVE OVIEDO, FL 32765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| HARRY S ROSS3 | 3013 COVE VIEW LN MIDLOTHIAN, VA 23112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL OF NORTH TEXAS INSURANCE G | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| SANDRA DRIVER3 | 1703 TAMARACK DRIVE WYLIE, TX 78052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS | 9500 KOGER BLVD ST PETERSBURG, FL 33702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| ANDREA DARLENE KRAMER3 | 12027 N 193RD AVE COLLINSVILLE, OK 74021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BRIAN JASON FISHER3 | 16501 SPOTTED EAGLE DRIVE LEANDER, TX 78641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JENNIFER A THOMPSON3 Filed as: JENNIFER THOMPSON | 48433 BEAVER VALLEY RD VALLEY SPRINGS, SD 57068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 284 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 284 | $117K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 284 | $117K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 284 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.