| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $112K | $116K | 4.02% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY, INC. | 1787 SENTRY PKWY W VEVA 16 STE 320 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $59K | $59K | 2.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $5K | $5K | 0.19% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 941114646 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $111K | $55K | $166K | 20.57% |
| COMPSYCH3 Filed as: COMPSYCH 35-3739783 | 455 N CITYFRONT PLAZA DR NBC TOWER CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $32K | $32K | 3.96% |
| HERITAGE PROVIDER NETWORK3 | 44469 10TH STREET WEST LANCASTER, CA 93534 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $22K | $22K | 2.73% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $806 | $806 | 0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 NORTH CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | UNITEDHEALTHCARE INSURANCE COMPANY | $17K | $33K | $50K | 8.38% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 941114646 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $12K | — | $12K | 2.78% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $23K | $1K | $25K | 13.80% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $17K | $47 | $17K | 10.36% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $16K | $534 | $17K | 13.92% |
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA UNIONDALE, NY 11556 | UNITEDHEALTHCARE INSURANCE COMPANY | $985 | — | $985 | 1.33% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $371 | $8K | 13.97% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 22 CORPORATE WOODS BOULEVARD ALBANY, NY 12211 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $6K | $167 | $6K | 11.19% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $82 | $4K | 11.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 NORTH CENTRAL AVE FLOOR 9 PHOENIX, AZ 85012 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 16.71% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $868 | $4K | 12.77% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST STE 200 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $968 | — | $968 | 2.99% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $8 | $8 | 0.02% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $771 | $4K | 12.50% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST STE 200 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $972 | — | $972 | 3.28% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6 | $6 | 0.02% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $605 | $3K | 13.16% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST STE 200 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $560 | — | $560 | 2.56% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5 | $5 | 0.02% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | — | $2K | 10.63% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY INC | 1305 WALT WHITMAN ROAD SUITE 310 MELVILLE, NY 11747 | SHELTERPOINT LIFE INSURANCE CO | $2K | — | $2K | 17.00% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY INC | 1305 WALT WHITMAN ROAD SUITE 310 MELVILLE, NY 11747 | SHELTERPOINT LIFE INSURANCE CO | $2K | — | $2K | 18.41% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $911 | $16 | $927 | 10.02% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $862 | — | $862 | 10.48% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $688 | — | $688 | 8.88% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $767 | $29 | $796 | 12.68% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $1K | $121 | $1K | 25.78% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $406 | — | $406 | 11.30% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $375 | — | $375 | 10.69% |
| DAVID PAPERNO4 | 78347 GRAPE ARBOR AVE PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $136 | — | $136 | 4.87% |
| CHRISTA G AUFDEMEBERG4 | 13102 BRITTANY WOODS DR TUSTIN, CA 92782 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $131 | — | $131 | 4.70% |
| NEW CHARTERS LLC4 | PO BOX 8927 ELIZABETH, NJ 07201 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $31 | — | $31 | 1.11% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $167 | — | $167 | 11.59% |
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 | 4,054 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,081 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 491 | $3.5M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3,396 | $5.0M |
| Vision(3 contracts, 2 carriers) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 4,852 | $467K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,813 | $808K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,813 | $841K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,813 | $808K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 238 | $594K |
| Other(20 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,813 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,852 | — |
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.