| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HIGHWAY BUILDING 2 SUITE 125 AUSTIN, TX 78746 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $11K | $11K | 0.43% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | 3 PARKWAY N SUITE 500 DEERFIELD, IL 60015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $39K | — | $39K | 2.10% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.08% |
| MICHAEL A BOOK3 | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $7K | $28K | $35K | 16.62% |
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT PYKOSZ | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $13K | $542 | $14K | 6.57% |
| GREGORY KARL LARGE3 | 281 TRESSER BOULEVARD SUITE 1004 STAMFORD, CT 069013238 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $7K | $564 | $7K | 3.54% |
| RICHARD PIERCE VANBENSCHOTEN3 | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | — | $1K | 0.48% |
| JOSHUA T LIEBERMAN3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 606063611 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $504 | $225 | $729 | 0.35% |
| ANDREW L MOORE3 | 3620 SOLAMERE DRIVE PARK CITY, UT 840608840 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | $648 | $648 | 0.31% |
| JOHN J MILLER3 Filed as: JOHN LEPORE | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $230 | $322 | $552 | 0.26% |
| HUCK GREEN3 | 444 S FLOWER STREET SUITE 4200 LOS ANGELES, CA 90071 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $431 | $18 | $449 | 0.21% |
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT PYKOSZ | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $266 | — | $266 | 0.13% |
| ALAN RICHARD3 Filed as: ALAN RICHARD STREITER | 2 STAMFORD PLAZA SUITE 1004 281 TRESSER BOULEVARD STAMFORD, CT 069013263 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $236 | $20 | $256 | 0.12% |
| PETE BOUROS3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IA 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $150 | — | $150 | 0.07% |
| MICHAEL A BOOK3 Filed as: MICHAEL RITZ | FL 18 90 PARK AVENUE NEW YORK, NY 100161322 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $69 | — | $69 | 0.03% |
| JENNIFER PAIGE MANN3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $61 | — | $61 | 0.03% |
| RICARDO M ALFONSO3 | 2100 PONCE DE LEON BLVD SUITE 600 CORAL GABLES, FL 331345215 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $49 | — | $49 | 0.02% |
| CALVIN E CHUNG3 | 973 WILLOW ROAD WINNETKA, IL 600933634 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $38 | — | $38 | 0.02% |
| JARAD PLUMMER3 | 1 N FRANKLIN STREET SUITE 3330 CHICAGO, IL 60606 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $28 | — | $28 | 0.01% |
| MICHAEL A BOOK3 | 90 PARK AVENUE FLOOR 17 NEW YORK, NY 100161373 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | $18 | $18 | 0.01% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,222 | $2.6M |
| Vision | VISION SERVICE PLAN | 4,773 | $556K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,375 | $1.9M |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,375 | $2.1M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,375 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,375 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.