| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 5575 D GLENDRIDGE DRIVE, SUITE 350 ATLANTA, GA 30328 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $19K | $152K | $171K | 6.27% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 D GLENRIDGE DRIVE, SUITE 350 ATLANTA, GA 30328 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $22K | — | $22K | 0.79% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | RELIASTAR LIFE INSURANCE COMPANY | $213 | $15 | $228 | 0.02% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 4.40% |
| BRUNO MARK3 Filed as: BRUNO F. MARK | 2881 SOUTH VALLEY VIEW BOULEVARD SUITE 8 LAS VEGAS, NV 89102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.75% |
| BRUNO MARK3 Filed as: BRUNO MARK FINANCIAL INC | 2881 SOUTH VALLEY VIEW BOULEVARD SUITE 8 LAS VEGAS, NV 89102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $598 | — | $598 | 0.26% |
| JO ANN PANTALONE3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $271 | — | $271 | 0.12% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $173 | — | $173 | 0.07% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN SERVICES INC | 1200 CORPORATE BOULEVARD, 2ND FLOOR LANCASTER, PA 17601 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $94 | $23 | $117 | 0.05% |
| MJ INSURANCE3 Filed as: BEARPAW BENEFITS AND VARIOUS AGENTS | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 0.04% |
| DESIGN BENEFITS INC3 Filed as: DESIGN SERVICES INC | 1200 CORPORATE BOULEVARD LANCASTER, PA 17601 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $90 | — | $90 | 2.78% |
| BETTY A. BOTELHO3 | 55008 COUNTRY ROAD 88 MODEL, CO 81059 | AFLAC | $90 | — | $90 | 4.82% |
| MJ INSURANCE3 Filed as: DON BOTELHO AND VARIOUS AGENTS | 55008 COUNTRY ROAD 88 MODEL, CO 81059 | AFLAC | $22 | — | $22 | 1.18% |
| MYTLE D. EASTON3 | 2166 HIGH STREET NW WARREN, OH 44483 | AFLAC | $21 | — | $21 | 1.12% |
| AMERICAN FINANCIAL SERVICES UNLTD.3 | 5125 QWUENDO ROAD, SUITE 10 LAS VEGAS, NV 89118 | AFLAC | $21 | — | $21 | 1.12% |
| RGK AND ASSOCIATES INC3 | 862 BARTLET LANE THE VILLAGES, FL 32162 | AFLAC | $17 | — | $17 | 0.91% |
| ANDREW F. JR. RUSSO3 Filed as: ANDREW F. RUSSO JR. | PO BOX 174 RICHLAND, OR 97870 | AFLAC | $14 | — | $14 | 0.75% |
| TOMMY MCKEE3 Filed as: TOMMY A. MCKEE | 2685 SOUTH RAINBOW BOULEVARD SUITE 109 LAS VEGAS, NV 89146 | AFLAC | $12 | — | $12 | 0.64% |
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 | 10,213 | 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) | 10,213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 41 | $508K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 41 | $216K |
| Life insurance(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 10,213 | $4.2M |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 10,213 | $2.7M |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 10,213 | $2.7M |
| Prescription drug(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 41 | $508K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 10,213 | $4.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,213 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.