| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | $164 | $19K | 1.75% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF NV LLC | 5985 HOME GARDENS DRIVE, SUITE A LAS VEGAS, NY 89119 | UNITEDHEALTHCARE INSURANCE COMPANY | -$5 | $32 | $27 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $379 | $0 | $379 | 4.05% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $264 | $32 | $296 | 3.16% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $205 | $77 | $282 | 3.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 751 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $274 | $0 | $274 | 2.93% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $87 | $60 | $147 | 1.57% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF NV LLC | 5985 HOME GARDENS DRIVE, SUITE A RENO, NY 89119 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | $0 | $67 | 0.72% |
| MJ INSURANCE3 Filed as: MCO PARTNERS AND VARIOUS AGENTS | 315 WEST 39TH STREET, SUITE 303 NEW YORK, NY 10018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $55 | $7 | $62 | 0.66% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF NV LLC | 375 EAST WARM SPRINGS ROAD SUITE 201 LAS VEGAS, NV 89119 | PRINCIPAL LIFE INSURANCE COMPANY | $305 | $0 | $305 | 13.37% |
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 | 91 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 91 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 218 | $1.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 218 | $1.1M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 3 | $2K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 12 | $9K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 3 | $2K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 218 | $1.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 12 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.