| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | PO BOX 6718 SOMERSET, NJ 08875 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $166K | — | $166K | 6.74% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 1.08% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST, INC. | PO BOX 7505 FORT WASHIGNTON, PA 19034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $666 | $8 | $674 | 2.50% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $270 | — | $270 | 1.00% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11 | — | $11 | 0.04% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | 648 VILLAGE PARK DR. UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 2.40% |
| SCHNELL, PAUL, ALAN3 Filed as: SCHNELL, PAUL ALAN | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10173 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 2.40% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST, INC. | PO BOX 7505 FORT WASHINGTON, PA 19034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $39 | $7 | $46 | 1.67% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 1.02% |
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 | 2,351 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 793 | $5.7M |
| Dental | DELTA DENTAL OF OHIO | 4,411 | $1.6M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 3,777 | $196K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,887 | $2.5M |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,887 | $2.5M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,887 | $2.5M |
| Other(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 3,887 | $8.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,411 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.