| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAYMOND DICK3 | 44824 CEDAR AVE. LANCASTER, CA 93534 | METROPOLITAN LIFE INSURANCE COMPANY | $68K | $30K | $97K | 5.77% |
| RAYMOND DICK3 | 108 VALLEY CREEK CT. FRANKLIN, TN 37064 | KAISER FOUNDATION HEALTH PLANS, INC. | $51K | — | $51K | 5.10% |
| RAYMOND DICK3 | 108 VALLEY CREEK CT. FRANKLIN, TN 37064 | KAISER FOUNDATION HEALTH PLANS, INC. | $37K | — | $37K | 3.77% |
| RAYMOND DICK3 | 108 VALLEY CREEK CT. FRANKLIN, TN 37064 | SYMETRA LIFE INSURANCE COMPANY | $35K | — | $35K | 7.00% |
| HORIZON INSURANCE COMPANY3 Filed as: HORIZON HEALTHCARE INSURANCE AGENCY | 3 PENN PLAZA E. NEWARK, NJ 07105 | SYMETRA LIFE INSURANCE COMPANY | — | $20K | $20K | 4.04% |
| RAYMOND DICK3 | 108 VALLEY CREEK CT. FRANKLIN, TN 37064 | VISION SERVICE PLAN | $3K | — | $3K | 2.54% |
| DEBORAH ALEXAKOS3 | 5475 N MITCHUM AVE. MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 7.21% |
| RAYMOND J DICK3 Filed as: RAYMOND J. DICK | 108 VALLEY CREEK CT. FRANKLIN, TN 37064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.54% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $804 | $541 | $1K | 1.90% |
| HURTADO & ASSOCIATES LLC3 | 13948 HALCOURT AVE. NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $602 | — | $602 | 0.85% |
| LUIS ERNESTO PEREZ3 | 861 KENWOOD ST. UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.21% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST. KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | $1 | $115 | 0.16% |
| DENNIS L HUMPHREY3 Filed as: DENNIS L. HUMPHREY | 3114 BROOKHAVEN COURT DEER PARK, TX 77536 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | — | $109 | 0.15% |
| DARCY COON3 | 1392 PENINSULA POINT LAS VEGAS, NV 89123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.08% |
| KELLY BRONNENBERG COON3 | 523 VIA ZARACOZA CT. LAS VEGAS, NV 89123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.08% |
| CHRISTINE LYNN MORGESTER3 | 9405 NE 100TH WAY VANCOUVER, WA 98662 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.07% |
| ROSS LAPHAM3 | 13772 ELM SHORES DR. HOUSTON, TX 77044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.05% |
| FRANK GILLELAND3 | 182 MEADOWLARK LANE FITZGERALD, GA 31750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.05% |
| PARAGON ADVISORY LLC3 | 501 NE 5TH TERRACE FT. LAUDERDALE, FL 33301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.05% |
| WINNIE L LAMBERT3 Filed as: WINNIE L. LAMBERT | 501 NE 5TH TERRACE FT. LAUDERDALE, FL 33301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.04% |
| BARNETT BENEFITS GROUP INC3 Filed as: BARNETT BENEFITS GROUP, INC. | 101 BARNETT RD. LONOKE, AR 72086 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.04% |
| DEBBIE BLACK3 | 4401 ROSS ST. AMARILLO, TX 79118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.04% |
| JAMES H CROUTHAMEL3 Filed as: JAMES H. CROUTHAMEL | 1308 CUSHMORE RD SOUTHAMPTON, PA 18966 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.03% |
| LAURIE J BURNS3 Filed as: LAURIE J. BURNS | 303 PLYLER RD. INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.03% |
| JILL R LAMBERT3 Filed as: JILL DICE-MALGIER | 17 MIDBRIDGE DR. MEDFORD, NJ 08055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.03% |
| JOHNSTONE INSURANCE SERVICES LLC3 | 706 OLIVE ST PITTSBURGH, PA 15237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| THERESA NETTO PHILLIPS3 | 6219 S CLARA FRESNO, CA 93706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DR. GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| SHANE G ROSS3 Filed as: SHANE G. ROSS | 8721 PREDERA CT. RANCHO CUCAMONGA, CA 91730 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| DIANE G. DAVIDSON3 | 72 HIGH STREET BUTLER, NJ 07405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| DAVID J MCCLELLAN3 Filed as: DAVID E. WYATT | 1011 N 49TH AVE. OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| CREATIVE EMPLOYEE BENEFIT SERVICES3 | P.O. BOX 83278 BATON ROUGE, LA 70884 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 3 PENN PLAZA NEWARK, NJ 071052200 | $369K |
| FRANK VISCO & ASSOCIATES INSURANCE AGENT/BROKER | Insurance agents and brokers Service code 22 | 44824 N. CEDAR DRIVE LANCASTER, CA 93534 | $32K |
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 | 3,060 | 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) | 3,060 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 3,060 | $1.7M |
| Vision | VISION SERVICE PLAN | 901 | $105K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,060 | $1.8M |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,060 | $1.8M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 3,060 | $1.7M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 878 | $500K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 3,060 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,060 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.