| 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 | $45K | — | $45K | 1.50% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | RELIASTAR LIFE INSURANCE COMPANY | $51K | — | $51K | 6.90% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $3K | $3K | 7.08% |
| JOSEPH LOUIS PANTALONE3 | CUSTOM BENEFIT PROGRAMS, INC. 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.96% |
| 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 | $1 | — | $1 | 0.00% |
| DESIGN BENEFITS INC3 Filed as: DESIGN SERVICES, INC. | 1200 CORPORATE BOULEVARD LANCASTER, PA 17601 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $91 | — | $91 | 3.09% |
| BETTY A. BOTELHO3 | 55008 COUNTRY ROAD 88 MODEL, CO 81059 | AFLAC | $70 | — | $70 | 5.76% |
| MYTLE D. EASTON3 | 102 WEST BEAUMONT ROAD COLUMBUS, OH 43214 | AFLAC | $14 | — | $14 | 1.15% |
| ANDREW F. JR. RUSSO3 Filed as: ANDREW RUSSO, JR. AND OTHER AGENTS | PO BOX 174 RICHLAND, OR 97870 | AFLAC | $13 | — | $13 | 1.07% |
| RGK AND ASSOCIATES INC3 | 862 BARTLET LANE THE VILLAGES, FL 32162 | AFLAC | $13 | — | $13 | 1.07% |
| AMERICAN FINANCIAL SERVICES UNLTD.3 | 5125 OQUENDO ROAD, SUITE 10 LAS VEGAS, NV 89118 | AFLAC | $10 | — | $10 | 0.82% |
| DON BOTELHO3 | 55008 COUNTY ROAD 88 MODEL, CO 81059 | AFLAC | $9 | — | $9 | 0.74% |
| TOMMY MCKEE3 Filed as: TOMMY A. MCKEE | 2685 SOUTH RAINBOW BOULEVARD SUITE 109 LAS VEGAS, NV 89146 | AFLAC | $8 | — | $8 | 0.66% |
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 | 9,780 | 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) | 9,780 | 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. | 17,428 | $1.8M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 41 | $225K |
| Life insurance(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 9,799 | $3.7M |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 9,799 | $3.0M |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 9,799 | $3.0M |
| Prescription drug(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 17,428 | $1.8M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 9,799 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 17,428 | — |
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.