| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE | $33K | — | $33K | 20.93% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT, INC. | 8144 WALNUT HILL LANE SUITE 1600 DALLAS, TX 75231 | AMERICAN HERITAGE LIFE INSURANCE | $14K | — | $14K | 8.56% |
| DANIEL E JUND3 | 3333 SOUTH BREA CANYON ROAD SUITE 108 DIAMOND BAR, CA 91765 | AMERICAN HERITAGE LIFE INSURANCE | $1K | — | $1K | 0.79% |
| VISUAL BENEFIT COMMUNICATIONS INC3 Filed as: VISUAL BENEFIT | 7500 SOUTH MEMORIAL PARKWAY SUITE 211 HUNTSVILLE, AL 35802 | AMERICAN HERITAGE LIFE INSURANCE | $407 | — | $407 | 0.26% |
| HEATHER DIANE MCFARLAND3 Filed as: HEATHER MCFARLAND | 695 LOVE BRANCH ROAD HARVEST, AL 35749 | AMERICAN HERITAGE LIFE INSURANCE | $25 | — | $25 | 0.02% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 20.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT INC | 8144 WALNUT HILL LANE SUITE 1600 DALLAS, TX 75231 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 8.41% |
| DANIEL E JUND3 | 3333 S BREA CANYON ROAD SUITE 108 DIAMOND BAR, CA 91765 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $128 | — | $128 | 0.78% |
| VISUAL BENEFIT COMMUNICATIONS INC3 Filed as: VISUAL BENEFIT | 7500 SOUTH MEMORIAL PARKWAY SUITE 211 HUNTSVILLE, AL 35802 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.09% |
| HEATHER DIANE MCFARLAND3 Filed as: HEATHER MCFARLAND | 695 LOVE BRANCH ROAD HARVEST, AL 35749 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $1.7M |
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 NONE | Other fees Service code 99 | — | $63K |
| ALERE EIN 20-0231080 NONE | Other fees Service code 99 | — | $3K |
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 | 5,485 | 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) | 5,485 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 94 | $629K |
| Vision | VISION SERVICE PLAN | 2,150 | $193K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,521 | $587K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,538 | $159K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 2,550 | $1.5M |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,485 | $703K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,485 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.