| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NICHOLAS J CIANCI3 | 21 MEADOWS WOOD DRIVE SUFFIELD, CT 06078 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $27K | — | $27K | 3.80% |
| NICHOLAS J CIANCI3 | 21 MEADOW WOOD DRIVE SUFFIELD, CT 06078 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.97% |
| NICHOLAS J CIANCI3 Filed as: NICHOLAS CIANCI | 21 MEADOW WOOD DRIVE SUFFIELD, CT 06078 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | — | $8K | 7.69% |
| THOMAS P MCKIERNAN3 | 20 JAMES STREET MILFORD, CT 06460 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | — | $8K | 7.64% |
| NICHOLAS J CIANCI3 Filed as: NICHOLAS CIANCI | 65 LASALLE ROAD SUITE 200 WEST HARTFORD, CT 06107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 4.13% |
| JORDAN D EMMANS3 | 438 WEST 26TH AVENUE SPOKANE, WA 99203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.42% |
| CHRISTOPHER M. MCKIERNAN3 Filed as: CHRISTOPHER M MCKIERNAN | 109 BOSTON POST ROAD ORANGE, CT 06477 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.29% |
| STEPHEN WEST3 | 5 JANE STREET BEACON FALLS, CT 06403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.00% |
| STEPHEN WEST3 | 5 JANE STREET BEACON FALLS, CT 06403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $762 | — | $762 | 0.75% |
| JUSTIN M BUCK3 | 71 DEEPWOOD DRIVE MADISON, CT 06443 | CONTINENTAL AMERICAN INSURANCE COMPANY | $759 | — | $759 | 0.74% |
| DENISE POIRIER3 Filed as: DENISE C POIRIER | 41 BENZ STREET ANSONIA, CT 06401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $689 | — | $689 | 0.67% |
| FRANK GREGORY PUTNEY3 Filed as: FRANK G PUTNEY | 11 BALAUREL DRIVE GUILFORD, CT 06437 | CONTINENTAL AMERICAN INSURANCE COMPANY | $686 | — | $686 | 0.67% |
| JEANNETTE A COLE3 | 23 CLIFF STREET EAST HAVEN, CT 06512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $555 | — | $555 | 0.54% |
| KENNETH C GRAVELINE3 | 109 BOSTON POST ROAD ORANGE, CT 06477 | CONTINENTAL AMERICAN INSURANCE COMPANY | $273 | — | $273 | 0.27% |
| JOHANN S SCRIMSHIRE3 | 125 SOUTH MAIN STREET SUITE 405 SEBASTOPOL, CA 95472 | CONTINENTAL AMERICAN INSURANCE COMPANY | $250 | — | $250 | 0.24% |
| CHRIS D BOULDREY3 | 340 WOOD HILLS DRIVE CONCORD, MI 49237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $246 | — | $246 | 0.24% |
| KENNETH C GRAVELINE3 | 109 BOSTON POST ROAD ORANGE, CT 06477 | CONTINENTAL AMERICAN INSURANCE COMPANY | $244 | — | $244 | 0.24% |
| ZACK PLOTZKER3 | 8759 CASHIO STREET LOS ANGELES, CA 90035 | CONTINENTAL AMERICAN INSURANCE COMPANY | $234 | — | $234 | 0.23% |
| JORDAN D EMMANS3 | 438 WEST 26TH AVENUE SPOKANE, WA 99203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $211 | — | $211 | 0.21% |
| JAIME PUERTA3 | 28443 SANTA CATARINA ROAD SANTA CLARITA, CA 91350 | CONTINENTAL AMERICAN INSURANCE COMPANY | $209 | — | $209 | 0.20% |
| CHRIS D BOULDREY3 | 340 WOOD HILLS DRIVE CONCORD, MI 49237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $164 | — | $164 | 0.16% |
| ZACK PLOTZKER3 | 8759 CASHIO STREET LOS ANGELES, CA 90035 | CONTINENTAL AMERICAN INSURANCE COMPANY | $156 | — | $156 | 0.15% |
| JOHANN S SCRIMSHIRE3 | 125 SOUTH MAIN STREET SUITE 405 SEBASTOPOL, CA 95472 | CONTINENTAL AMERICAN INSURANCE COMPANY | $152 | — | $152 | 0.15% |
| GEORGE E ARBID3 | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | CONTINENTAL AMERICAN INSURANCE COMPANY | $152 | — | $152 | 0.15% |
| JAIME PUERTA3 | 28443 SANTA CATARINA ROAD SANTA CLARITA, CA 91350 | CONTINENTAL AMERICAN INSURANCE COMPANY | $139 | — | $139 | 0.14% |
| KAREN BUCK3 Filed as: KAREN E BUCK | 71 DEEPWOOD DRIVE MADISON, CT 06443 | CONTINENTAL AMERICAN INSURANCE COMPANY | $130 | — | $130 | 0.13% |
| CHRISTOPHER M. MCKIERNAN3 Filed as: CHRISTOPHER M MCKIERNAN | 109 BOSTON POST ROAD ORANGE, CT 06477 | CONTINENTAL AMERICAN INSURANCE COMPANY | $93 | — | $93 | 0.09% |
| DANIEL J BAKLEY3 | 600 COLLEGE AVENUE UNIT B SANTA ROSA, CA 95404 | CONTINENTAL AMERICAN INSURANCE COMPANY | $74 | — | $74 | 0.07% |
| DEAN F SHIPMAN3 | 13600 OWEN ROAD BROOKLYN, MI 49230 | CONTINENTAL AMERICAN INSURANCE COMPANY | $73 | — | $73 | 0.07% |
| LISA M HALL3 | 2542 EAST SUNDOWN DRIVE COEUR D ALENE, ID 83815 | CONTINENTAL AMERICAN INSURANCE COMPANY | $72 | — | $72 | 0.07% |
| ASHLEY M. MESSENGER3 Filed as: ASHLEY M MESSENGER | 4200 WEST MICHIGAN AVENUE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | — | $58 | 0.06% |
| SAHAR QABAZARD3 | 3756 DEER TRAIL COURT DANVILLE, CA 94506 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | — | $58 | 0.06% |
| TERRY K ALLEN3 | PO BOX 13406 SPOKANE, WA 99213 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| NICHOLAS J CIANCI3 | 21 MEADOWS WOOD DRIVE SUFFIELD, CT 06078 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $471 | — | $471 | 3.15% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 104 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 77 | $724K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 342 | $212K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $110K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 0 | $187K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 342 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.