| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TGL ASSOCIATES LLC3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17K | $3K | $20K | 9.12% |
| LANA L WILHITE LLC3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $208 | $8K | 3.59% |
| GAYE ANN HOLLOMAN3 | 934 E WEBSTER STREET SPRINGFIELD, MO 65802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $213 | $4K | 1.69% |
| DALE E WASHBURN3 | 133 POINT SEVEN ROAD KIMBERLING CITY, MO 65686 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $47 | $2K | 0.99% |
| DEBORAH L MCCURTER3 | 3046 S DELAWARE SPRINGFIELD, MO 65804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $63 | $2K | 0.99% |
| TANA L MAY3 | PO BOX 455 HARRISON, AR 72602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $22 | $1K | 0.51% |
| RALPH E ZIMMERMAN3 | 248 E MONTASTERY ST #237 SPRINGFIELD, MO 65810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $461 | — | $461 | 0.21% |
| LAUREN ELIZABETH SUTLEY3 | 468 COUNTY ROAD 163 NEW BROCKTON, AL 36351 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $177 | — | $177 | 0.08% |
| MCFADDEN BENEFIT MANAGEMENT INC3 | 5852 KENNEDY DR FAYETTEVILLE, AR 72704 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | $32 | $164 | 0.08% |
| EDITH VIEYRA3 | 1432 EAST MARKET STREET LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $153 | — | $153 | 0.07% |
| KYLE HARDING3 | 520 W 12TH ST TEXARKANA, TX 75501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $39 | $148 | 0.07% |
| ISIDORO ZEICHNER3 | 525 C STREET APT 401 SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $146 | — | $146 | 0.07% |
| ANAHI RIES3 | 1110 OHIO AVE LONG BEACH, CA 90804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $133 | — | $133 | 0.06% |
| MAIRA MAGALI ORTIZ3 | 43642 35TH ST EAST LANCASTER, CA 93535 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $125 | $5 | $130 | 0.06% |
| COMPLETE BUSINESS BENEFITS INC3 | 3751 HONEYSUCKLE COURT MONTGOMERY, AL 36109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $95 | $30 | $125 | 0.06% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 0.03% |
| MARKS BENEFIT MANAGEMENT LLC3 | 4257 N GABEL DR FAYETTEVILLE, AR 72703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.03% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE RD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.02% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.02% |
| MGW SERVICES LLC3 | 26060 ACERO MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.01% |
| HAD LI ENTERPRISES INCORPORATED3 | 11432 SOUTH ST #303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $2 | $28 | 0.01% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.01% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.01% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $8 | $18 | 0.01% |
| STACIA ROBINSON3 | 6008 E SHIRLEY LANE MONTGOMERY, AL 36117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $1 | $13 | 0.01% |
| PAUL STANLEY JR3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| KEYSHA LATRICE GWIN3 | 1357 SOUTH STANLEY DRIVE LOS ANGELES, CA 90019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $4 | $12 | 0.01% |
| BENEFITS COORDINATOR3 | 10741 LA JARA ST CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| D'ARCIPRETE & ASSOCIATES INC3 Filed as: D'ARCIPRETE AND ASSOCIATES INC | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 9908 WELLINGTON WAY FORT SMITH, AR 72908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| AMY M ESTES3 | 30 SAMFORD AVE OPELIKA, AL 36801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| ANN MARIE THOMAS LLC3 | 4205 W. CHESTNUT EXPRESSWAY SPRINGFIELD, MO 65802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| CHRISTINE L COURTNEY3 | 333 WEEKSRIDGE LN MONCKS CORNER, SC 29461 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MEMBER BENEFITS INSURANCE SERVICES3 | 25702 PATTERSON PLACE LAGUNA HILLS, CA 92653 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MITCHELL H BESVINICK3 | 1280 BRIGHTON WAY NEWTOWN SQUARE, PA 19073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BRYCE ALEXANDER KORNGOLD3 | 25702 PATTERSON PLACE LAGUNA HILLS, CA 92653 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BETH JOAN MITCHELL3 | 5264 INTERNATIONAL BLVD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BRYAN EDWARD BEETS Filed as: BRYAN EDWARDS BEETS | 1028 EAST MAIN ST PRATTVILLE, AL 36066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVE STE #212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| FRANCINE KING3 | 21802 MIRADOR MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| EDITH VIEYRA3 Filed as: EDITH PONCE DAVILA | 363 E 69TH WAY LONG BEACH, CA 90805 | 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 | $0 | 0.00% |
| JOHN TAYLOR3 | 4240 E BRIDGEWATER LANE FAYETTEVILLE, AR 72703 | USABLE LIFE | $241 | — | $241 | 0.70% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: JERRY DUNCAN C/O ARKANSAS BCBS | 516 EAST MILLSAP ROAD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $48 | — | $48 | 0.14% |
| JOHN TAYLOR3 | 4240 E BRIDGEWATER LANE FAYETTEVILLE, AR 72703 | USABLE LIFE | $196 | — | $196 | 0.70% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: JERRY DUNCAN C/O ARKANSAS BCBS | 516 EAST MILLSAP ROAD STE 103 FAYETTEVILLE, AR 72703 | USABLE LIFE | $39 | — | $39 | 0.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC EIN 43-1420563 PHAMACEUTICAL BENEFIT MAN | Other fees Service code 99 | — | $322K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $197K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Other commissions Service code 55 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | $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 | 509 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARKANSAS | 465 | $134K |
| Vision | ARKANSAS BLUE CROSS AND BLUE SHIELD | 422 | $46K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 397 | $252K |
| Short-term disability | USABLE LIFE | 257 | $28K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 287 | $364K |
| Other | USABLE LIFE | 397 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 465 | — |
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."
No prospect flags tripped on this filing.