| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TGL ASSOCIATES LLC3 | 3046 SOUTH DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17K | $2K | $19K | 8.56% |
| LANA L WILHITE LLC3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $875 | $9K | 3.90% |
| DALE E WASHBURN3 | 133 POINT SEVEN ROAD KIMBERLING CITY, MO 65686 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $21 | $3K | 1.32% |
| GAYE ANN HOLLOMAN3 | 934 E WEBSTER STREET SPRINGFIELD, MO 65802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $128 | $2K | 0.86% |
| DEBORAH L MCCURTER3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $8 | $2K | 0.82% |
| ISIDORO ZEICHNER3 | 525 C STREET APT 401 SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $892 | $64 | $956 | 0.43% |
| RALPH E ZIMMERMAN3 | 248 E MONASTERY ST #237 SPRINGFIELD, MO 65810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $912 | $2 | $914 | 0.41% |
| COMPLETE BUSINESS BENEFITS INC3 | 3751 HONEYSUCKLE COURT MONTGOMERY, AL 36109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $455 | $235 | $690 | 0.31% |
| MAIRA MAGALI ORTIZ3 | 43642 35TH ST EAST LANCASTER, CA 93535 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $647 | $30 | $677 | 0.30% |
| LAUREN ELIZABETH SUTLEY3 | 818 AUTUMN RIDGE RD MONTGOMERY, AL 36117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $374 | $50 | $424 | 0.19% |
| ANAHI RIES3 | 1110 OHIO AVE LONG BEACH, CA 90804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $274 | $37 | $311 | 0.14% |
| WILLIAM NEAL SCHUMAKER3 | PO BOX 989 NIXA, MO 65714 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $186 | — | $186 | 0.08% |
| EDITH VIEYRA3 | 1432 EAST MARKET STREET LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $176 | $1 | $177 | 0.08% |
| HAD LI ENTERPRISES INCORPORATED3 | 11432 SOUTH ST #303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | $7 | $79 | 0.04% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | $4 | $77 | 0.03% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $42 | $75 | 0.03% |
| MARKS BENEFIT MANAGEMENT LLC3 | 4257 N GABEL DR FAYETTEVILLE, AR 72703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.03% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.03% |
| STACIA ROBINSON3 | 6008 E SHIRLEY LANE MONTGOMERY, AL 36117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $6 | $63 | 0.03% |
| MCFADDEN BENEFIT MANAGEMENT INC3 | 5852 KENNEDY DR FAYETTEVILLE, AR 72704 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.02% |
| KEYSHA LATRICE GWIN3 | 1357 SOUTH STANLEY DRIVE LOS ANGELES, CA 90019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $5 | $49 | 0.02% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVE STE #212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $28 | $43 | 0.02% |
| EDITH VIEYRA3 Filed as: EDITH PONCE DAVILA | 363 E 69TH WAY LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $2 | $37 | 0.02% |
| BRYAN EDWARD BEETS3 | 1028 EAST MAIN STREET PRATTVILLE, AL 36066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $16 | $34 | 0.02% |
| KYLE HARDING3 | 520 W 12TH ST TEXARKANA, TX 75501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.01% |
| MGW SERVICES LLC3 | 26060 ACERO MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.01% |
| YACXIRI LIZBETH LOPEZ-DELGADO3 | 10345 SOUTH GATE, CA 90280 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.01% |
| GINNY ELIZABETH CRISTALES3 | 43 COUNTRY MILE RD POMONA, CA 91766 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 9908 WELLINGTON WAY FORT SMITH, AR 72908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.01% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.01% |
| PAUL STANLEY JR3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $5 | $19 | 0.01% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE RD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| ASHLEY WIMBERLEY SKELTON3 | 1300 MAGNOLIA CURVE MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $5 | $13 | 0.01% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| AMY M ESTES3 | 7404 COPPERFIELD DRIVE MONTGOMERY, AL 36117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $2 | $11 | 0.00% |
| BENEFITS COORDINATOR3 | 10741 LA JARA ST CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| DONNA M GEABHART3 | 1500 JENNIFER ST SPRINGDALE, AR 72762 | 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 | $1 | $6 | 0.00% |
| MITCHELL H BESVINICK3 | 1280 BRIGHTON WAY NEWTOWN SQ, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.00% |
| BRYCE ALEXANDER KORNGOLD3 | 25702 PATTERSON PLACE LAGUNA HILLS, CA 92653 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| FRANCINE KING3 | 21802 MIRADOR MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| TINA HERNANDEZ3 | 11779 W COCOPAH ST AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | 0.00% |
| JOHN TAYLOR3 | 4240 E BRIDGEWATER LANE FAYETTLEVILE, AR 72703 | USABLE LIFE | $238 | — | $238 | 0.71% |
| JERRY DUNCAN3 | 516 EAST MILLSAP ROAD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $50 | — | $50 | 0.15% |
| JOHN TAYLOR3 | 4240 E BRIDGEWATER LANE FAYTTEVILLE, AR 72703 | USABLE LIFE | $189 | — | $189 | 0.70% |
| JERRY DUNCAN3 | 516 EAST MILLSAP ROAD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $40 | — | $40 | 0.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC EIN 43-1420563 PHARMACY BENEFIT MGMT | Other fees Service code 99 | — | $315K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $249K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Other commissions Service code 55 | — | $54K |
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 | 510 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 510 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARKANSAS | 446 | $139K |
| Vision | ARKANSAS BLUE CROSS AND BLUE SHIELD | 533 | $43K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 394 | $255K |
| Short-term disability | USABLE LIFE | 250 | $27K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 283 | $359K |
| Other | USABLE LIFE | 394 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.