| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $32K | $232K | $264K | 3.65% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $8K | $18K | 9.27% |
| O'NEILL VOLUNTARY BENEFIT SERVICES3 | 5626 KIRKWOOD HIGHWAY WILMINGTON, DE 19808 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $2K | $20K | 17.47% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE DALLAS, TX 75201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $894 | $13K | 11.09% |
| NICHOLAS CUSMANO3 Filed as: NICHOLAS CUSMANO AND VAR. AGENTS | 79 PORT HERMAN ROAD CHESAPEAKE CITY, MD 21915 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $105 | $2K | 2.03% |
| DARLENE BLAASCH3 | 701 SOUTH BROAD STREET MIDDLETOWN, DE 19709 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $431 | $2K | 1.47% |
| ROTH VOLUNTARY BENEFIT SERVICES INC3 Filed as: ROTH VOLUNTARY BEN. SERVICES, INC. | 9 DEARBORN LANE BEAR, DE 19701 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 1.24% |
| BRAD BIEL3 Filed as: BRAD LEE MUNDY | 108 BALMORE LANE WILMINGTON, DE 19808 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $39 | $1K | 1.05% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DRIVE MURRIETA, CA 92562 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $894 | $204 | $1K | 0.97% |
| WILLIAM S. WHITE4 | 20150 BOWMAN ROAD COTTONWOOD, CA 96022 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $65 | $0 | $65 | 1.72% |
| LOIS A. THRELKELD4 | 10736 JEFFERSON BOULEVARD SUITE 798 CULVER CITY, CA 90230 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $27 | $0 | $27 | 0.72% |
| CARPE DIEM LP4 Filed as: CARPE DIEM, LP | 4833 FRONT STREET, SUITE B105 CASTLE ROCK, CO 80104 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $12 | $0 | $12 | 0.32% |
| SHONNA V. GOTTSCHLICH4 | 1800 GERHARD DRIVE SANTA ROSA, CA 95401 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $11 | $0 | $11 | 0.29% |
| O'NEILL VOLUNTARY BENEFIT SERVICES3 | 5626 KIRKWOOD HIGHWAY WILMINGTON, DE 19808 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $230 | $22 | $252 | 12.13% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $95 | $7 | $102 | 4.91% |
| MELISSA A KOLL | 216 CLIMAX DRIVE DILLON, CO 80435 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.48% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CO, LLC | 1700 BROADWAY, SUITE 1000 DENVER, CO 80290 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.34% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.29% |
| SARA SORENSEN-CONNICK3 Filed as: SARA SORENSEN-CONNICK AND VAR AGT | 8547 EAST ARAPAHOE GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.24% |
| OPTIO LLC3 Filed as: OPTIO, LLC | 8547 EAST ARAPAHOE ROAD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.14% |
| O'NEILL VOLUNTARY BENEFIT SERVICES3 | 5626 KIRKWOOD HIGHWAY WILMINGTON, DE 19808 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $132 | $12 | $144 | 12.11% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE DALLAS, TX 75201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $4 | $61 | 5.13% |
| SARA SORENSEN-CONNICK3 Filed as: SARA SORENSEN-CONNICK AND VAR AGTS | 8547 EAST ARAPAHOE GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.17% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.08% |
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 | 921 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 931 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 974 | $7.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 974 | $7.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 974 | $7.2M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $311K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $198K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 974 | $7.2M |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,277 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.