| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 333 WEST WACKER DRIVE CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY LLC | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DRIVE CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $388 | $388 | 0.47% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 333 WEST WACKER DRIVE CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DRIVE CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $205 | $205 | 0.46% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE LLC | 333 WEST WACKER DRIVE CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY LLC | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DRIVE CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $184 | $184 | 0.46% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 333 WEST WACKER DRIVE CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $320 | — | $320 | 10.01% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $160 | $160 | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DRIVE CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $25 | $25 | 0.78% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 220 | $44K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 171 | $82K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 83 | $40K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 96 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.