| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | PO BOX 28031 NEW YORK, NY 100874465 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $65K | $71K | 5.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | PO BOX 28031 NEW YORK, NY 100874465 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | $0 | $10K | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| JOSEPH J DERTHICK3 | 15428 FLATBUSH AVE. NORWALK, CA 90650 | AFLAC | $175 | $0 | $175 | 2.16% |
| LEMUEL E FRANKS3 | 2812 GREENFIELD DR EDMOND, OK 73012 | AFLAC | $147 | $0 | $147 | 1.81% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS CT STE. 210 BURBANK, CA 91501 | AFLAC | $129 | $0 | $129 | 1.59% |
| SETH JAFFE3 Filed as: SETH L JAFFE | 4127 E MASSACHUSETTS ST. LONG BEACH, CA 90814 | AFLAC | $93 | $0 | $93 | 1.15% |
| KATHLEEN S HANSON3 | 5460 E EL PARQUE ST. LONG BEACH, CA 90815 | AFLAC | $50 | $0 | $50 | 0.62% |
| DAVID J REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | AFLAC | $40 | $0 | $40 | 0.49% |
| LINDA M NAPOLI3 | 17631 VENTURA BLVD #321 ENCINO, CA 91316 | AFLAC | $32 | $0 | $32 | 0.39% |
| DAVID ANDREW PEPIN3 | 4176 STATE HIGHWAY, M35 ESCANABA, MI 49829 | AFLAC | $26 | $0 | $26 | 0.32% |
| STEPHANIE WOOLEY3 Filed as: STEPHANIE E WOOLEY | PO BOX 8127 BACLIFF, TX 77518 | AFLAC | $17 | $0 | $17 | 0.21% |
| SHEM J BOSTICK3 | 1620 S DITMAR ST. OCEANSIDE, CA 92054 | AFLAC | $15 | $0 | $15 | 0.18% |
| RAVONE MARVELLE GRAHAM3 | 7601 ARCADIA TRL FORT WORTH, TX 76137 | AFLAC | $10 | $0 | $10 | 0.12% |
| CHAD HAINES3 Filed as: CHAD W HAINES | 108 WROXTON DR. CONROE, TX 77304 | AFLAC | $9 | $0 | $9 | 0.11% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $8 | $0 | $8 | 0.10% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE. 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $7 | $0 | $7 | 0.09% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD., STE. 204 NASHVILLE, TN 37215 | AFLAC | $7 | $0 | $7 | 0.09% |
| HAMMIE WARD III3 | 8907 SILVER YACHT DR HUMBLE, TX 77346 | AFLAC | $6 | $0 | $6 | 0.07% |
| MST INSURANCE SOLUTIONS, INC.3 Filed as: MST INSURANCE SOLUTIONS INC | 21241 S WESTERN AVE, STE 200 TORRANCE, CA 90501 | AFLAC | $6 | $0 | $6 | 0.07% |
| JEFFERY S GIBSON3 | 4030 TATES CREEK RD, APT 1007 LEXINGTON, KY 40517 | AFLAC | $6 | $0 | $6 | 0.07% |
| JEFFREY C WEST3 Filed as: JEFFREY WEST | 2466 FM 1697 LEDBETTER, TX 78946 | AFLAC | $5 | $0 | $5 | 0.06% |
| BARRY MCPHERSON INC3 | 3928 IRONBARK WAY MCKINNEY, TX 75071 | AFLAC | $2 | $0 | $2 | 0.02% |
| KIM REED SMITH3 | 7815 DEERWOOD LAKE DR. HUMBLE, TX 77346 | AFLAC | $1 | $0 | $1 | 0.01% |
| OWEN JOHNSTON3 | 2414 N TUSTIN AVE, APT O2 SANTA ANA, CA 92705 | AFLAC | $1 | $0 | $1 | 0.01% |
| DALE IRA DAVIS3 | 5892 CEDARCREEK LANE LEXINGTON, KY 40515 | AFLAC | $1 | $0 | $1 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $106 | $0 | $106 | 14.99% |
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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 96 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 96 | $1.4M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 96 | $1.4M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 94 | $25K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 94 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 96 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.