| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 60143 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $64K | $0 | $64K | 7.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 0.99% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $890 | $890 | 0.10% |
| DEBORAH ALEXAKOS3 | 5475 N MITCHUM AVENUE MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $0 | $13K | 2.95% |
| RAYMOND DICK3 Filed as: RAYMOND J DICK | 108 VALLEY CREEK COURT FRANKLIN, TN 37064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $0 | $12K | 2.69% |
| LUIS ERNESTO PEREZ3 | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $210 | $5K | 1.06% |
| HURTADO & ASSOCIATES LLC3 | 13948 HALCOURT AVENUE NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.53% |
| FRANCISCO X CABRERA3 | 8616 PALMER COURT MCKINNEY, TX 75070 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $186 | $2K | 0.42% |
| SHANE G ROSS3 | 8721 PREDERA COURT RANCHO CUCAMONGA, CA 91730 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $70 | $1K | 0.34% |
| RONNY ANN WARNER3 | 470 E WHITBECK STREET KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $887 | $0 | $887 | 0.20% |
| CYNTHIA LERNER RUBIN3 Filed as: CYNTHIA P WHALEN | 123 PINE VALLEY DRIVE MIDDLETOWN, DE 19709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $529 | $158 | $687 | 0.16% |
| RUBEN D PEREZ3 | 6352 ALCORN AVENUE DALLAS, TX 75217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $637 | $0 | $637 | 0.15% |
| ELIZABETH REYNERTSON3 | 4725 ROSEBANK DRIVE LA CANADA, CA 91011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $567 | $0 | $567 | 0.13% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $424 | $143 | $567 | 0.13% |
| RICHARD WILLIAM FRIEDMAN3 | 23927 RUSTICO COURT SANTA CLARITA, CA 91354 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $441 | $77 | $518 | 0.12% |
| BURTON M HERRING JR3 | 1135 ARLINGTON DRIVE BIRMINGHAM, AL 35224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $471 | $38 | $509 | 0.12% |
| LORI LYNN PIERCE3 | 5909 CINNAMON OAKS DRIVE CORPUS CHRISTI, TX 78414 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $348 | $0 | $348 | 0.08% |
| NORWOOD BENEFIT SERVICES INC3 | 6478 LONG BREEZE ROAD ORLANDO, FL 32810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $276 | $16 | $292 | 0.07% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $240 | $48 | $288 | 0.07% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $161 | $109 | $270 | 0.06% |
| MANDY M WIEDEMAN3 | 3422 LEANING PINE DRIVE LINCOLNTON, NC 28092 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $191 | $14 | $205 | 0.05% |
| MARLIN P DANIELSEN3 | 286 BORING CHAPEL ROAD GRAY, TN 37615 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $164 | $13 | $177 | 0.04% |
| MARY-JOYCE LICATA3 | 583 HATCHERY ROAD NORTH KINGSTOWN, RI 02852 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $144 | $0 | $144 | 0.03% |
| TAMMY SUE FOWLER3 | 5513 FOX RUN DRIVE CORPUS CHRISTI, TX 78413 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | $0 | $137 | 0.03% |
| CD FRAZIER ASSOCIATES INC3 | 8631 STONEFACE ROAD CHARLOTTE, NC 28214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $0 | $122 | 0.03% |
| SUSAN FONTANA FLYNN3 | 8814 EAGLE POINT DRIVE KNOXVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | $10 | $96 | 0.02% |
| STEPHEN M HENSS LLC3 | 44 HERSHEY LANE PARKSBURG, PA 19365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $29 | $87 | 0.02% |
| CAPSTONE BENEFIT SOLUTIONS LLC3 | 901 LAKESIDE CIRCLE LEWISVILLE, TX 75057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $0 | $59 | 0.01% |
| EDWARD H SPATER3 | PO BOX 351 EAST BROOKFIELD, MA 01515 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $2 | $57 | 0.01% |
| JOE FERNANDEZ3 | 6136 FRISCO SQUARE BOULEVARD FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $8 | $53 | 0.01% |
| TODD BOOZER3 Filed as: TODD A BOOZER | 2900 CAHABA ROAD BIRMINGHAM, AL 35223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $24 | $51 | 0.01% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $14 | $48 | 0.01% |
| LYNN MARIE BARRY3 Filed as: LYNN M MCLEOD | 93 SCHOOL HOUSE ROAD MILLS RIVER, NC 28759 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $11 | $40 | 0.01% |
| WILLIAM RENNARD3 | 3001 ALOMA AVENUE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $11 | $38 | 0.01% |
| ETHAN EXELBERT3 | 64 4TH AVENUE BROOKLYN, NY 11217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 0.01% |
| JAKORP INC3 | 14458 CRESTWOOD AVENUE POWAY, CA 92064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $18 | $36 | 0.01% |
| GENEVIEVE CARELLI3 | 547 CLEO LANE DELTONA, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 0.01% |
| HOWARD HOROWITZ3 Filed as: HOWARD P DILEMA | 55 BROADWAY NEW YORK, NY 10006 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $24 | $30 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $9 | $27 | 0.01% |
| ALLYN INCORPORATED3 | 3013 BROOKFIELD LANE CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 0.01% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $14 | $24 | 0.01% |
| PENELOPE DEAN KENNY3 | 3555 S OCEAN BOULEVARD APARTMENT 215 S PALM BEACH, FL 33480 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $2 | $23 | 0.01% |
| JAMES M EANES3 | 1700 E JACKSON STREET PENSACOLA, FL 32501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $6 | $18 | 0.00% |
| ARIADNE DE BASABE-MACHICHE3 | 1825 KINGSFORD DRIVE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $4 | $16 | 0.00% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.00% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $1 | $13 | 0.00% |
| BILLY MARK ROBERSON3 | 17415 SHADY CANYON SAN ANTONIO, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.00% |
| OMAR MENDOZA3 | 26326 ROCKWALL PARKWAY NEW BRAUNFELS, TX 78132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.00% |
| EMMA ANN DEAN3 | 350 SOUTH BELVEDERE DRIVE HAMPSTEAD, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| MITCHELL HECTOR MORALES3 | PO BOX 2532 NORCROSS, GA 30091 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| TROY J PALMER3 | 15534 CLOVER RIDGE SAN ANTONIO, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| EDWARD JOHN MCNEIL3 | 27 LEE ROAD MEDFIELD, MA 02052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.00% |
| KLD INSURANCE BENEFITS INC3 | 8045 ROYAL SAINT GEORGES LANE DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.00% |
| WALKER INS AND FIN SER INC3 | PO BOX 532115 ORLANDO, FL 32853 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| SONYA L KINCH3 | 470 PLEASANT STREET NORWOOD, MA 02062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| JOHN D EVANGELISTA3 | 29811 SANTA MARGARITA PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| DUSTIN SNYDER3 | 34606 SHALLOT DRIVE WINCHESTER, CA 92596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| WAYNE RIMMER3 | 7454 FARMERS ROAD PENSACOLA, FL 32526 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| GERALD A SANFTNER3 | 3306 KIRKWOOD DRIVE RAPID CITY, SD 57702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| DAVID L FLEURY3 | 545 SOUTH MAIN STREET PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| ROSEANN REYNOLDS3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| VENESSA N DEAN3 | 92 LIMEWOOD AVENUE BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $0 | $14K | 7.50% |
| DEBORAH ALEXAKOS3 | 5475 N MITCHUM AVENUE MERIDIAN, ID 83646 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.13% |
| RAYMOND DICK3 Filed as: RAYMOND J DICK | 108 VALLEY CREEK COURT FRANKLIN, TN 37064 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GEORGE HILLENBRAND | 347 WEAST ROAD SCHENECTADY, NY 12306 | THE PAUL REVERE LIFE INSURANCE COMPANY | $884 | $39 | $923 | 1.82% |
| LORRAIN RHODES3 | 1465 ROUTE 29 GALWAY, NY 12074 | THE PAUL REVERE LIFE INSURANCE COMPANY | $84 | $45 | $129 | 0.25% |
| MEGAN Z CULVER3 Filed as: MEGAN Z HARRIS | 3 GORING PLACE WAPPINGERS FALLS, NY 12590 | THE PAUL REVERE LIFE INSURANCE COMPANY | $55 | $2 | $57 | 0.11% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE #112 TORRANCE, CA 90501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $24 | $3 | $27 | 0.05% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | $3 | $17 | 0.03% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | THE PAUL REVERE LIFE INSURANCE COMPANY | $16 | $0 | $16 | 0.03% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| APRIL ALLEN3 | 4517 WOLF SPRING DRIVE LOUISVILLE, KY 40241 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| AIKEN ENTERPRISES LLC3 | 341 GILLIGAN ROAD HUDSON, NY 12534 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.5M |
| AON CONSULTING, INC. EIN 22-2232264 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $67K |
| VISCO & ASSOCIATES EIN 56-7491638 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $53K |
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 | 4,109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 11,861 | $848K |
| Short-term disability(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 4,109 | $581K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,459 | $184K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 11,861 | $848K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,861 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.