| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | BLUECROSS BLUESHIELD OF ILLINOIS | $19K | $1K | $20K | 4.46% |
| HEALTH SOLUTIONS INSURANCE AGENCY3 | 184 WORCESTER PROVIDENCE SUTTON, MA 01590 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $8K | $2K | $10K | 2.76% |
| ACRISURE LLC3 Filed as: ACRISURE HEALTH SOLUTIONS INS AGENC | DBA HEALTH SOLUTIONS INS AGCY 184 WORCESTER PROVIDENCE TPK SUTTON, MA 01590 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $5K | $403 | $5K | 2.88% |
| THE HEALTH SOLUTIONS INSURANCE AGCY3 Filed as: THE HEALTH SOLUTIONS INSURANCE AGEN | 184 WORCESTER PROVIDENCE TPK SUTTON, MA 01590 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | — | $891 | $891 | 0.51% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CREATIVE RISK MANAGEMENT | PO BOX 650 NYACK, NY 10960 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $9K | — | $9K | 9.49% |
| HJM GROUP, INC.3 | 207 BRIARWOOD DRIVE SOMERS, NY 10589 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.14% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $4K | $10K | 14.55% |
| MJ INSURANCE3 Filed as: MARK C PIETSCH AND VARIOUS AGENTS | 1751 LAKE COOK ROAD DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $54 | — | $54 | 0.08% |
| LAURA MARIE MEADS3 | 15084 ARDLEY HALL CT SHELBY TWP, MI 48315 | KC LIFE | $3K | — | $3K | 6.74% |
| THE HEALTH SOLUTIONS INSURANCE AGCY3 | 184 WORCESTER PROVIDENCE TPK SUTTON, MA 015902902 | BLUECROSS BLUESHIELD OF MASSACHUSETTS, INC. | $2K | $90 | $2K | 6.43% |
| ACRISURE LLC3 Filed as: ACRISURE HEALTH SOLUTIONS INS | 184 WORCESTER PROVIDENCE TPK SUTTON, MA 015902902 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $696 | — | $696 | 8.97% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | ONE ENTERPRISE DR STE 210 SHELTON, CT 06484 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $258 | $258 | 3.32% |
| TAYLOR & TAYLOR ASSOCIATES3 Filed as: TAYLOR & TAYLOR ASSOCIATES, INC. | 271 MADISON AVENUE NEW YORK, NY 10016 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $311 | — | $311 | 14.98% |
No Schedule C service providers reported on this filing.
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 | 1,013 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,018 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 121 | $2.4M |
| Dental(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $145K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 477 | $136K |
| Life insurance(4 contracts, 4 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 995 | $244K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $115K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 73 | $67K |
| Other(5 contracts, 5 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 995 | $246K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 995 | — |
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.