| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 624949 VIRGINIA BEACH, VA 23466 | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | $63 | $2K | $2K | 0.15% |
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY STREET FARMINGTON, MO 63640 | DELTA DENTAL OF MISSOURI | $8K | — | $8K | 11.42% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MISSOURI | $83 | — | $83 | 0.12% |
| JOHN W NISWONGER3 | 525 COUNTY ROAD 233 CAPE GIRARDEAU, MO 63701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $528 | $6K | 9.63% |
| DAVID NISWONGER3 | 8561 EVERETT AVENUE ST LOUIS, MO 63117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.35% |
| LISA D NISWONGER3 | 2711 THOMAS DRIVE CAPE GIRARDEAU, MO 63701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $37 | $1K | 1.75% |
| JOSEPH NISWONGER3 | 787 VAIL DRIVE JACKSON, MO 63755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $982 | $48 | $1K | 1.70% |
| LAURA A RHEIN3 | 101 SCHLUETER GERMAINE ROAD BELLEVILLE, IL 62220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $800 | $210 | $1K | 1.66% |
| JENNIFER ROWLAND3 | 205 N SUNSET BLVD CAPE GIRARDEAU, MO 63701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $789 | $71 | $860 | 1.42% |
| SANFORD GARY GOLDBERG3 | 222 GOOD HOPE STREET CAPE GIRARDEAU, MO 63703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $183 | — | $183 | 0.30% |
| JO ANN PANTALONE3 Filed as: ANN M WEST | 1600 MIDAMERICA ST UNIT 1613 PERRYVILLE, MO 63775 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $145 | — | $145 | 0.24% |
| LAWRENCE A SCHRADER3 | 5631 CHALET FOREST DRIVE ST LOUIS, MO 63129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $133 | — | $133 | 0.22% |
| MEGAN ELIZABETH GONCHER | 2231 SILVER CAMPINE LN CAPE GIRARDEAU, MO 63701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY FARMINGTON, MO 63640 | ANTHEM LIFE INSURANCE COMPANY | $40K | — | $40K | 154.96% |
| FIRST STATE INSURANCE AGENCY3 Filed as: FIRST STATE INSURANCE AGENCY INC | 204 E LIBERTY STREET FARMINGTON, MO 63640 | ADVANTICA INSURANCE COMPANY | $1K | — | $1K | 9.70% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE STE 350 VALHALLA, NY 10595 | ADVANTICA INSURANCE COMPANY | $20 | — | $20 | 0.13% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 114 | $1.4M |
| Dental | DELTA DENTAL OF MISSOURI | 267 | $69K |
| Vision | ADVANTICA INSURANCE COMPANY | 220 | $15K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 207 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.