| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TGL ASSOCIATES LLC3 | 3046 SOUTH DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21K | $5K | $26K | 13.44% |
| LANA L WILHITE LLC3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $2K | $10K | 5.08% |
| DALE E WASHBURN3 | 133 POINT SEVEN ROAD KIMBERLING CITY, MO 65686 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $150 | $3K | 1.53% |
| DEBORAH L MCCURTER3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $53 | $2K | 0.93% |
| WILLIAM NEAL SCHUMAKER3 | PO BOX 989 NIXA, MO 65714 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $18 | $2K | 0.90% |
| RALPH E ZIMMERMAN3 | 248 E MONASTERY ST #237 SPRINGFIELD, MO 65810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $27 | $1K | 0.73% |
| LAUREN ELIZABETH SUTLEY3 | 818 AUTUMN RIDGE RD MONTGOMERY, AL 36117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $22 | $1K | 0.63% |
| GAYE ANN HOLLOMAN3 | PO BOX 243 JOPLIN, MO 64802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $99 | $1K | 0.61% |
| ANAHI RIES3 | 1110 OHIO AVE LONG BEACH, CA 90804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $669 | $468 | $1K | 0.59% |
| EDITH VIEYRA3 | 1432 EAST MARKET STREET LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $368 | $179 | $547 | 0.28% |
| YACXIRI LIZBETH LOPEZ-DELGADO3 | 10345 SOUTH GATE, CA 90280 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | $212 | $286 | 0.15% |
| EDITH VIEYRA3 Filed as: EDITH PONCE DAVILA | 363 E 69TH WAY LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $44 | $178 | 0.09% |
| BRYAN EDWARD BEETS3 | 1028 EAST MAIN STREET PRATTVILLE, AL 36066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | $95 | $162 | 0.08% |
| GINNY ELIZABETH CRISTALES3 | 43 COUNTRY MILE RD POMONA, CA 91766 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | $23 | $153 | 0.08% |
| HAD LI ENTERPRISES INCORPORATED3 | 11432 SOUTH ST #303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $36 | $138 | 0.07% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $72 | $118 | 0.06% |
| NORMA ALICIA PUENTES3 | 9944 CEDAR ST BELLFLOWER, CA 90706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.04% |
| MARKS BENEFIT MANAGEMENT LLC3 | 4257 N GABEL DR FAYETTEVILLE, AR 72703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $1 | $65 | 0.03% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVE STE #212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $43 | $65 | 0.03% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.03% |
| ASHLEY WIMBERLEY SKELTON3 | 1300 MAGNOLIA CURVE MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $15 | $61 | 0.03% |
| MCFADDEN BENEFIT MANAGEMENT INC3 | 5852 KENNEDY DR FAYETTEVILLE, AR 72704 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $0 | $50 | 0.03% |
| AMY M ESTES3 | 7404 COPPERFIELD DRIVE MONTGOMERY, AL 36117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $23 | $44 | 0.02% |
| KYLE HARDING3 | 520 W 12TH ST TEXARKANA, TX 75501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $1 | $32 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 9908 WELLINGTON WAY FORT SMITH, AR 72908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.01% |
| PAUL STANLEY JR3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $11 | $23 | 0.01% |
| MGW SERVICES LLC3 | 26060 ACERO MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.01% |
| DONNA M GEABHART3 | 1500 JENNIFER ST SPRINGDALE, AR 72762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE RD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| BENEFITS COORDINATOR3 | PO BOX 727 ARTESIA, CA 90702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $5 | $9 | 0.00% |
| MITCHELL H BESVINICK3 | 1280 BRIGHTON WAY NEWTON, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| CHRISTINE L COURTNEY3 | 333 WEEKSRIDGE LN MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 0.00% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| BRYCE ALEXANDER KORNGOLD3 | 25702 PATTERSON PLACE LAGUNA HILLS, CA 92653 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| FRANCINE KING3 | 21802 MIRADOR MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| TINA HERNANDEZ3 | 11258 WEST LINCOLN ST AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | 0.00% |
| JOHN TAYLOR3 | 4240 E BRIDGEWATER LANE FAYETTLEVILE, AR 72703 | USABLE LIFE | $301 | — | $301 | 0.91% |
| JERRY DUNCAN3 Filed as: JERRY DUNCAN C/O AR BLUE CROSS | 516 EAST MILLSAP ROAD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $60 | — | $60 | 0.18% |
| JOHN TAYLOR3 | 4240 E BRIDGEWATER LANE FAYTTEVILLE, AR 72703 | USABLE LIFE | $219 | — | $219 | 0.88% |
| JERRY DUNCAN3 Filed as: JERRY DUNCAN C/O AR BLUE CROSS | 516 EAST MILLSAP ROAD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $44 | — | $44 | 0.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Direct payment from the plan; Float revenue; Claims processing Service code 12 | — | $319K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $173K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Other commissions Service code 55 | — | $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 | 533 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 535 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARKANSAS | 435 | $126K |
| Vision | ARKANSAS BLUE CROSS AND BLUE SHIELD | 397 | $43K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 372 | $225K |
| Short-term disability | USABLE LIFE | 232 | $25K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE INSURANCE & HEALTH INS CO. | 283 | $328K |
| Other | USABLE LIFE | 372 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 435 | — |
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.